Sala C, Morganti A, Ferraris P, Ardeleani G, Venegoni P, Quorso P, Ambrosi B, Zanchetti A
Istituto di Clinica Medica Generale, Università di Milano, Italy.
J Hypertens Suppl. 1988 Dec;6(4):S336-8. doi: 10.1097/00004872-198812040-00104.
Both dopamine and atrial natriuretic factor (ANF) are known to suppress aldosterone secretion. Since it is possible that dopaminergic mechanisms facilitate ANF release, we investigated the relationship between these two inhibitory systems by comparing the increases in aldosterone induced by metoclopramide, a dopaminergic antagonist, with decreases in ANF. Aldosterone, ANF, prolactin, plasma renin activity, cortisol and potassium were measured before and after the intravenous injection of 10 mg metoclopramide, blood samples being collected at 15-min intervals up to 2 h after the injection. These studies were performed in patients with essential hypertension who were maintained on a constant sodium intake (100 mmol/day), before and after 5 days of treatment with ibopamine, an orally active dopamine analogue. Before ibopamine metoclopramide induced the expected, marked increases in aldosterone and in prolactin, but only minimal, non-significant decreases in ANF. All other humoral parameters, as well as blood pressure and heart rate, were unaffected by metoclopramide. After ibopamine treatment, which caused a transient natriuretic effect, the responses of aldosterone and of ANF to metoclopramide were similar to those observed in control studies, whereas that of prolactin was enhanced. Thus, it appears that the suppressive effect exerted by the dopaminergic tone on aldosterone secretion is independent of ANF both before and after dopaminergic stimulation.
已知多巴胺和心房利钠因子（ANF）均可抑制醛固酮分泌。由于多巴胺能机制可能促进ANF释放，我们通过比较多巴胺能拮抗剂甲氧氯普胺诱导的醛固酮增加与ANF减少，来研究这两种抑制系统之间的关系。在静脉注射10mg甲氧氯普胺之前和之后，测量醛固酮、ANF、催乳素、血浆肾素活性、皮质醇和钾，在注射后长达2小时内每隔15分钟采集血样。这些研究在原发性高血压患者中进行，这些患者维持恒定的钠摄入量（100mmol/天），在口服活性多巴胺类似物异波帕胺治疗5天之前和之后进行。在使用异波帕胺之前，甲氧氯普胺诱导醛固酮和催乳素出现预期的显著增加，但ANF仅出现最小的、无统计学意义的降低。所有其他体液参数以及血压和心率均不受甲氧氯普胺影响。在异波帕胺治疗引起短暂利钠效应后，醛固酮和ANF对甲氧氯普胺的反应与对照研究中观察到的相似，而催乳素的反应增强。因此，似乎多巴胺能张力对醛固酮分泌的抑制作用在多巴胺能刺激之前和之后均独立于ANF。
