[慢性α肾上腺素能受体阻断对原发性高血压患者肾素基础分泌的影响]

[Effect of a chronic alpha adrenergic receptor blockade on basal secretion of renin in essential hypertension].

作者信息

Vetter H, Kolloch R, Appenheimer M, Cordt U, Glänzer K, Stumpe K O, Trübestein G, Weiand H, Witassek F, Krück F

出版信息

Schweiz Med Wochenschr. 1978 Dec 9;108(49):1978-81.

Abstract

To investigate the effect of chronic alpha-adrenergic receptor blockade on renin release, plasma renin activity (PRA) was determined overnight at short intervals in 9 patients with essential hypertension before and after 7 days medication with phenoxybenzamine (20 mg orally/day). Inhibition of basal (supine) renin secretion in response to alpha-adrenergic receptor blockade was more apparent in patients with elevated PRA (n = 3) than in those with normal PRA. On the other hand, patients with low PRA (n = 2) even showed an increase in renin release. In addition, night-day variations with secretory episodes in PRA were blunted during drug administration. It is suggested that alpha-adrenergic receptor blockade inhibits renin secretion distal to its blockade of specific adrenergic receptors. However, the increase in renin release during phenoxybenzamine observed in patients with low PRA indicates that the responsiveness of renin secretion to stimulatory effects (most probably induced by the lowered blood pressure in our patients) remained intact during alpha-adrenergic receptor blockade.

摘要

为研究慢性α-肾上腺素能受体阻滞对肾素释放的影响，在9例原发性高血压患者口服苯苄胺（20 mg/天）7天前后，短时间间隔内对其血浆肾素活性（PRA）进行了夜间测定。与PRA正常的患者相比，PRA升高的患者（n = 3）对α-肾上腺素能受体阻滞的反应中，基础（仰卧位）肾素分泌的抑制更为明显。另一方面，PRA较低的患者（n = 2）甚至出现肾素释放增加。此外，给药期间PRA的昼夜分泌变化及分泌峰被减弱。提示α-肾上腺素能受体阻滞在其阻断特定肾上腺素能受体的远端抑制肾素分泌。然而，低PRA患者在服用苯苄胺期间肾素释放增加，表明在α-肾上腺素能受体阻滞期间，肾素分泌对刺激作用（很可能由患者血压降低引起）的反应性仍保持完整。