Zaldívar H M, Posadas C, Manero L, Sánchez Torres G
Arch Inst Cardiol Mex. 1986 May-Jun;56(3):211-7.
Recent evidences suggest that the sympathetic nervous system plays a major role in the pathogenesis and maintenance of several clinical forms of hypertensive disease. The clonidine suppression test allows us to uncover the subtle changes in neuronal noradrenaline release in essential hypertension. To prove this possibility, we selected 16 patients: 7 borderline hypertensives (BH) (4 males and 3 females), mean age: 24 years; and 9 established hypertensives (EH) (6 males and 3 females), mean age: 25 years. In both groups, the heart rate (HR) and blood pressure (BP) were registered every 30 min and by intravenous catheter plasma catecholamines (PCA) and plasma renin activity (PRA) were measured before and after (180 and 240 min) one oral dosis of clonidine (300 mcg) had been administered. Patients remained in clinostatism for 180 and and orthostatism for 60 min. HR and BP diminished in BH and EH after clonidine during clinostatism in comparison to preclonidine period. PCA also showed reduction in 180 min with respect to the basaline period. PRA did not present change in 180 min in either groups in relation to time O. During orthostatism, HR increased in both groups with respect to the baseline period. BP remained low in relation to baseline time. PCA were increased with respect to preclonidine period. PRA showed a slight tendency to increase in relation to time O in both groups. CAP baseline level are not reliable indexes of the role of the sympathetic tone in maintenance of high BP values in hypertensive disease.(ABSTRACT TRUNCATED AT 250 WORDS)
近期证据表明,交感神经系统在几种高血压疾病临床类型的发病机制及维持过程中起主要作用。可乐定抑制试验能让我们发现原发性高血压中神经元去甲肾上腺素释放的细微变化。为证实这种可能性,我们选取了16例患者:7例临界高血压患者(BH)(4例男性,3例女性),平均年龄24岁;9例确诊高血压患者(EH)(6例男性,3例女性),平均年龄25岁。两组患者均每30分钟记录心率(HR)和血压(BP),并通过静脉导管在口服一剂可乐定(300微克)之前及之后(180和240分钟)测量血浆儿茶酚胺(PCA)和血浆肾素活性(PRA)。患者静卧180分钟,直立60分钟。与服用可乐定前相比,静卧时BH和EH患者服用可乐定后HR和BP降低。180分钟时PCA相对于基线期也降低。两组在180分钟时PRA相对于时间0均无变化。直立时,两组HR相对于基线期均升高。BP相对于基线时间仍较低。PCA相对于服用可乐定前升高。两组PRA相对于时间0均有轻微升高趋势。CAP基线水平并非高血压疾病中交感神经张力在维持高血压值方面作用的可靠指标。(摘要截断于250字)