van den Meiracker A H, Man in't Veld A J, Boomsma F, Blankestijn P J, Schalekamp M A
Department of Internal Medicine 1, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
J Hypertens Suppl. 1988 Dec;6(4):S558-61. doi: 10.1097/00004872-198812040-00175.
In a placebo-controlled randomized cross-over trial the effects of non-selective (bopindolol, 1 mg once daily for 1 week) and of beta 1-selective beta-adrenoceptor blockade (atenolol, 50 mg once daily for 1 week) on adrenaline-induced enhancement of basal and stimulated sympathetic activity were studied in 10 hypertensive subjects. During infusion of adrenaline (20 ng/kg per min) venous plasma adrenaline levels increased into the high physiological range. Resting concentrations of arterial plasma noradrenaline and of the basal production of noradrenaline in the forearm increased significantly (P less than 0.01) during infusion of adrenaline. The increases in these two indices of sympathetic activity were abolished by bopindolol and by atenolol. Arterial noradrenaline, but not noradrenaline production, also increased in response to isometric exercise, cold provocation and mental stress during infusion of adrenaline (P less than 0.05). These amplifications were also abolished by both beta-adrenoceptor antagonists. Our findings provide further evidence in man for a stimulatory effect of adrenaline in the physiological range on sympathetic activity. This effect, which is supposed to be mediated by prejunctional beta-adrenoceptors, can be blocked not only by non-selective, but also by beta 1-selective beta-adrenoceptor antagonists.
在一项安慰剂对照的随机交叉试验中,对10名高血压患者研究了非选择性β受体阻滞剂(波吲洛尔,每日1次,每次1 mg,共1周)和β1选择性β肾上腺素能受体阻滞剂(阿替洛尔,每日1次,每次50 mg,共1周)对肾上腺素诱导的基础和刺激的交感神经活动增强的影响。在输注肾上腺素(20 ng/kg每分钟)期间,静脉血浆肾上腺素水平升高至生理高值范围。在输注肾上腺素期间,动脉血浆去甲肾上腺素的静息浓度和前臂去甲肾上腺素的基础分泌量显著增加(P<0.01)。这两个交感神经活动指标的增加被波吲洛尔和阿替洛尔消除。在输注肾上腺素期间,等长运动、冷刺激和精神应激也会使动脉去甲肾上腺素增加,但去甲肾上腺素分泌量未增加(P<0.05)。这两种β肾上腺素能受体拮抗剂也消除了这些增强作用。我们的研究结果为肾上腺素在生理范围内对交感神经活动的刺激作用提供了进一步的人体证据。这种作用被认为是由突触前β肾上腺素能受体介导的,不仅可以被非选择性β受体阻滞剂阻断,也可以被β1选择性β肾上腺素能受体拮抗剂阻断。