胰岛素分泌的自主控制与心力衰竭的治疗
Autonomic control of insulin secretion and the treatment of heart failure.
作者信息
Majid P A, Saxton C, Dykes J R, Galvin M C, Taylor S H
出版信息
Br Med J. 1970 Nov 7;4(5731):328-34. doi: 10.1136/bmj.4.5731.328.
Abstract
To investigate the role of the autonomic nervous system in controlling insulin secretion 13 normal subjects and 5 patients with heart failure underwent insulin secretion tests. Alpha-adrenergic stimulation and beta-receptor blockade significantly depressed the secretion of insulin in response to intravenous tolbutamide in normal subjects, while both alpha-blockade and beta-stimulation significantly increased the insulin secretion response in both normal subjects and patients in heart failure. Parasympathetic stimulation and blockade had no significant effect on the insulin secretion response. These findings suggest that drugs that block the alpha-adrenergic receptors or stimulate the beta-adrenergic receptors by their ability to counteract the insulin suppression resulting from increased sympathetic nervous activity may play a vital metabolic part in the deranged metabolism of the failing heart in addition to their direct haemodynamic benefits.
摘要
为研究自主神经系统在控制胰岛素分泌中的作用，对13名正常受试者和5名心力衰竭患者进行了胰岛素分泌测试。α-肾上腺素能刺激和β-受体阻断显著降低了正常受试者静脉注射甲苯磺丁脲后的胰岛素分泌，而α-阻断和β-刺激在正常受试者和心力衰竭患者中均显著增加了胰岛素分泌反应。副交感神经刺激和阻断对胰岛素分泌反应无显著影响。这些发现表明，通过抵消交感神经活动增加导致的胰岛素抑制作用来阻断α-肾上腺素能受体或刺激β-肾上腺素能受体的药物，除了具有直接的血流动力学益处外，可能在衰竭心脏紊乱的代谢中发挥重要的代谢作用。
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