Itoh N
Third Department of Internal Medicine, Fukushima Medical College, Japan.
Nihon Naibunpi Gakkai Zasshi. 1988 May 20;64(5):419-38. doi: 10.1507/endocrine1927.64.5_419.
In the present study, effects of angiotensin on the adrenal steroidogenesis were studied in essential hypertension, primary aldosteronism and renovascular hypertension (RVH). Angiotensin III(A III), an analogue of angiotensin II, was administered to 17 normal volunteers (9 male and 8 female), 44 patients with essential hypertension (EH) (15 with high renin; HREH, 15 with normal renin; NREH and 14 with low renin; LREH), 8 patients with primary aldosteronism (5 with adrenal adenoma; APA and 3 with bilateral adrenocortical hyperplasia; IHA) and 5 patients with renovascular hypertension. In all the patients with hypertension and normal subjects, blood pressure (BP) and plasma concentrations of progesterone (P), corticosterone (B), aldosterone (Aldo), 17 alpha-hydroxyprogesterone(17-OHP) and cortisol(F) were measured before and after intravenous administration of A III (0.1, 0.5, 1.0, 10, 20 and 40 ng/kg/min, for 15 min, respectively). 1) BP rose from 164 +/- 19/88 +/- 8 to 180 +/- 19/112 +/- 10 mmHg [systolic BP(SBP); P less than 0.01, diastolic BP(DBP); P less than 0.01] in HREH, from 162 +/- 12/96 +/- 7 to 186 +/- 11/118 +/- 8 mmHg in NREH(SBP; P less than 0.01, DBP; P less than 0.01), 165 +/- 12/94 +/- 8 to 202 +/- 12/126 +/- 9 mmHg in LREH(SBP; P less than 0.001, P less than 0.001) and 118 +/- 8/72 +/- 7 mmHg to 136 +/- 11/88 +/- 8 mmHg in controls (SBP; P less than 0.01, DBP; P less than 0.01). The elevation in NREH and LREH was greater than that in HREH and controls. The elevations of BP both in APA and IHA were remarkably greater than that in controls and as similar as LREH(APA; 174 +/- 21/103 +/- 12 to 204 +/- 18/136 +/- 8 mmHg, IHA; 176 +/- 10/104 +/- 4 to 206 +/- 17/138 +/- 10 mmHg). The elevation in RVH was similar to that in NREH(173 +/- 9/108 +/- 8 to 194 +/- 13/132 +/- 10 mmHg). 2) Plasma P increased from 25.5 +/- 7.5 to 39.5 +/- 13.8 ng/100 ml(P less than 0.001) in HREH, from 28.0 +/- 7.7 to 45.3 +/- 12.7 ng/100 ml(P less than 0.001) in NREH, from 23.8 +/- 8.2 to 47.2 +/- 19.4 ng/100 ml(P less than 0.001) in LREH and 26.6 +/- 11.0 to 43.4 +/- 14.6 ng/100 ml in controls. The increment in HREH or NREH was similar to that in controls(P less than 0.1, respectively), whereas greater than controls in LREH(P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)
在本研究中，我们研究了血管紧张素对原发性高血压、原发性醛固酮增多症和肾血管性高血压（RVH）患者肾上腺类固醇生成的影响。血管紧张素II的类似物血管紧张素III（A III）被给予17名正常志愿者（9名男性和8名女性）、44例原发性高血压（EH）患者（15例高肾素型；HREH，15例正常肾素型；NREH和14例低肾素型；LREH）、8例原发性醛固酮增多症患者（5例肾上腺腺瘤型；APA和3例双侧肾上腺皮质增生型；IHA）以及5例肾血管性高血压患者。在所有高血压患者和正常受试者中，在静脉注射A III（分别为0.1、0.5、1.0、10、20和40 ng/kg/min，持续15分钟）前后，测量血压（BP）以及孕酮（P）、皮质酮（B）、醛固酮（Aldo）、17α-羟孕酮（17-OHP）和皮质醇（F）的血浆浓度。1）HREH患者的血压从164±19/88±8 mmHg升至180±19/112±10 mmHg [收缩压（SBP）；P<0.01，舒张压（DBP）；P<0.01]，NREH患者从162±12/96±7 mmHg升至186±11/118±8 mmHg（SBP；P<0.01，DBP；P<0.01），LREH患者从165±12/94±8 mmHg升至202±12/126±9 mmHg（SBP；P<0.001，DBP<0.001），对照组从118±8/72±7 mmHg升至136±11/88±8 mmHg（SBP；P<0.01，DBP；P<0.01）。NREH和LREH患者的血压升高幅度大于HREH患者和对照组。APA和IHA患者的血压升高幅度均显著大于对照组，且与LREH患者相似（APA：174±21/103±12 mmHg至204±18/136±8 mmHg，IHA：176±10/104±4 mmHg至206±17/138±10 mmHg）。RVH患者的血压升高幅度与NREH患者相似（173±9/108±8 mmHg至194±13/132±10 mmHg）。2）HREH患者血浆P从25.5±7.5 ng/100 ml增至39.5±13.8 ng/100 ml（P<0.001），NREH患者从28.0±7.7 ng/100 ml增至45.3±12.7 ng/100 ml（P<0.001），LREH患者从23.8±8.2 ng/100 ml增至47.2±19.4 ng/100 ml（P<0.001），对照组从26.6±11.0 ng/100 ml增至43.4±14.6 ng/100 ml。HREH或NREH患者的增加幅度与对照组相似（分别为P<0.1），而LREH患者大于对照组（P<0.05）。（摘要截断于400字）
