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[夜间支气管哮喘患儿与健康儿童皮质醇、儿茶酚胺、环磷酸腺苷及组胺的夜间变化]

[Nocturnal changes in cortisol, catecholamines, cAMP and histamine in children with nocturnal bronchial asthma and in healthy children].

作者信息

Zimmermann T, Nagel M

出版信息

Klin Padiatr. 1987 Mar-Apr;199(2):103-7. doi: 10.1055/s-2008-1026772.

Abstract

We analyzed the concentration of plasma epinephrine, norepinephrine, dopamine and C-AMP and urinary cortisol, histamine and creatinine in 28 children over a period from 4 p.m. to 8 a.m. 15 children were suffering from nocturnal asthma, 13 had no asthma problems. The cortisol-levels of both, the asthmatic and the healthy children were almost identical, the minimum cortisol-concentrations were found at 8 p.m. The concentration of plasma epinephrine in the asthmatic children was significantly higher than in the control group. Both groups showed minimum levels at 12 p.m. Plasma norepinephrine showed a continuous course with a raise in the early morning hours in both groups. Children without asthma had a continuous decrease of norepinephrine during the sleeping period and an increase in the early morning. Dopamine was significantly lower in the asthmatics. C-AMP was also on a lower level, but the difference between both groups was not significant. Histamine showed an extreme variability in the asthmatic children and was on higher levels during the whole period compared to the control group. The raised epinephrine levels in children with nocturnal asthma could be understood as compensation to a dysfunction of the receptor-transducer-adenylcyclase-complex of beta 2-receptors. A reduction of beta 2-receptors by anti-asthmatic therapy could also be responsible for these epinephrine levels. The significant difference in dopamine levels between children with and without nocturnal asthma is poorly understood. The increase of epinephrine and the decrease of dopamine could be caused by a modulated synthesis of catecholamines in children suffering from nocturnal asthma.

摘要

我们分析了28名儿童在下午4点至上午8点期间血浆肾上腺素、去甲肾上腺素、多巴胺和环磷酸腺苷(C-AMP)以及尿皮质醇、组胺和肌酐的浓度。15名儿童患有夜间哮喘,13名儿童没有哮喘问题。哮喘儿童和健康儿童的皮质醇水平几乎相同,最低皮质醇浓度出现在晚上8点。哮喘儿童血浆肾上腺素浓度显著高于对照组。两组在晚上12点时均显示出最低水平。血浆去甲肾上腺素呈持续变化过程,两组在清晨时均升高。无哮喘儿童在睡眠期间去甲肾上腺素持续下降,清晨时升高。哮喘儿童的多巴胺水平显著较低。C-AMP水平也较低,但两组之间的差异不显著。组胺在哮喘儿童中变化极大,与对照组相比,在整个时间段内均处于较高水平。夜间哮喘儿童肾上腺素水平升高可理解为对β2受体的受体-转导器-腺苷酸环化酶复合物功能障碍的一种代偿。抗哮喘治疗导致β2受体减少也可能是这些肾上腺素水平升高的原因。夜间哮喘儿童与无夜间哮喘儿童之间多巴胺水平的显著差异尚不清楚。夜间哮喘儿童肾上腺素升高和多巴胺降低可能是由于儿茶酚胺合成的调节所致。

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