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患有心脏肥大的高血压患者中血管加压素释放控制受损。

Impaired control of vasopressin release in hypertensive subjects with cardiac hypertrophy.

作者信息

Trimarco B, De Luca N, De Simone A, Volpe M, Ricciardelli B, Lembo G, Condorelli M

机构信息

Istituto di Clinica Medica I, II Facoltà di Medicina, Napoli, Italy.

出版信息

Hypertension. 1987 Dec;10(6):595-602. doi: 10.1161/01.hyp.10.6.595.

Abstract

The effects of graded lower body negative pressure (-10 and -40 mm Hg) on vascular resistance and plasma vasopressin, norepinephrine, and renin activity were assessed in seven hypertensive subjects with left ventricular hypertrophy and seven sex-matched and age-matched normotensive subjects. In both groups increasing levels of lower body negative pressure induced a progressive decrease in right atrial pressure and an increase in vascular resistance. In normal subjects plasma vasopressin, norepinephrine, and renin activity were progressively raised, whereas only the higher level of stimulation increased plasma renin activity, norepinephrine, and vasopressin in hypertensive subjects. Propranolol induced a significant increase in plasma vasopressin in normal subjects (from 1.3 +/- 0.1 to 2.0 +/- 0.1 pg/ml; p less than 0.05) but not in hypertensive subjects. In this latter condition -10 mm Hg lower body negative pressure failed to increase plasma vasopressin, norepinephrine, and renin activity in normal subjects. Propranolol abolished the change in plasma renin activity in both groups, reduced the increase in vascular resistance induced by -40 mm Hg lower body negative pressure in normotensive subjects, but did not modify the rise in vasopressin elicited by this stimulus in normal subjects or the humoral and hemodynamic reflex responses evoked in hypertensive subjects. These results suggest that cardiopulmonary receptors are involved in the control of vasopressin release in normal subjects, whereas in hypertensive subjects with left ventricular hypertrophy, this control is altered because of an impaired function of cardiopulmonary receptors.

摘要

在7名患有左心室肥厚的高血压患者和7名年龄及性别匹配的血压正常者中,评估了分级下体负压(-10和-40 mmHg)对血管阻力、血浆血管加压素、去甲肾上腺素和肾素活性的影响。在两组中,下体负压水平升高均导致右心房压力逐渐降低和血管阻力增加。在正常受试者中,血浆血管加压素、去甲肾上腺素和肾素活性逐渐升高,而在高血压患者中,只有较高水平的刺激才会增加血浆肾素活性、去甲肾上腺素和血管加压素。普萘洛尔使正常受试者的血浆血管加压素显著增加(从1.3±0.1 pg/ml增至2.0±0.1 pg/ml;p<0.05),但对高血压患者无此作用。在后一种情况下,-10 mmHg下体负压未能增加正常受试者的血浆血管加压素、去甲肾上腺素和肾素活性。普萘洛尔消除了两组中血浆肾素活性的变化,降低了血压正常者由-40 mmHg下体负压引起的血管阻力增加,但未改变此刺激在正常受试者中引起的血管加压素升高,也未改变高血压患者中诱发的体液和血流动力学反射反应。这些结果表明,心肺感受器参与正常受试者血管加压素释放的控制,而在患有左心室肥厚的高血压患者中,由于心肺感受器功能受损,这种控制发生了改变。

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