Cubeddu L X, Hoffmann I S, Davila S, Escontrelas C, Morales C, Rios A
Life Sci. 1986 Dec 22;39(25):2463-74. doi: 10.1016/0024-3205(86)90489-3.
This study was undertaken to investigate further the CNS actions of commonly employed antihypertensive drugs. Measurements of cerebrospinal fluid (CSF) and plasma catecholamines (CA) were made in an attempt to estimate the activity of central and peripheral noradrenergic neurons during treatment with or after abrupt discontinuation of treatment with clonidine (CLO), propranolol (PRO), hydrochlorothiazide (HCTZ) or placebo, in patients with essential hypertension. A randomized, parallel, placebo-controlled, single-blind design was employed. BP reductions equal to or greater than 10 mmHg were observed with CLO (0.36 +/- 0.07 mg daily), PRO (160 mg +/- 0 mg daily) or HCTZ (70 +/- 12 mg daily). CLO reduced plasma norepinephrine (NE) by 64% and PRO increased it by 25%. Neither HCTZ nor placebo modified plasma NE. Plasma renin activity (PRA) was reduced by PRO (51%, P less than 0.01) and CLO (35%, P less than 0.05). CSF-NE levels (pg/ml) were significantly lower in the CLO group (CLO: 175 +/- 23; PRO: 278 +/- 35; HCTZ: 255 +/- 34; placebo: 203 +/- 7).
本研究旨在进一步探究常用抗高血压药物对中枢神经系统的作用。对原发性高血压患者在使用可乐定（CLO）、普萘洛尔（PRO）、氢氯噻嗪（HCTZ）治疗期间或突然停药后，以及使用安慰剂时，测定脑脊液（CSF）和血浆儿茶酚胺（CA），试图评估中枢和外周去甲肾上腺素能神经元的活性。采用随机、平行、安慰剂对照、单盲设计。使用CLO（每日0.36±0.07毫克）、PRO（每日160毫克±0毫克）或HCTZ（每日70±12毫克）时观察到血压降低等于或大于10毫米汞柱。CLO使血浆去甲肾上腺素（NE）降低64%，PRO使其升高25%。HCTZ和安慰剂均未改变血浆NE。PRO（51%，P<0.01）和CLO（35%，P<0.05）使血浆肾素活性（PRA）降低。CLO组的脑脊液NE水平（皮克/毫升）显著较低（CLO：175±23；PRO：278±35；HCTZ：255±34；安慰剂：203±7）。
