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普萘洛尔和美托洛尔对尿毒症患者血浆甲状旁腺激素和降钙素浓度的急性影响。

Acute effects of propranolol and metoprolol on plasma concentrations of parathyroid hormone and calcitonin in uraemic patients.

作者信息

Coevoet B, Desplan C, Sebert J L, Makdassi R, Gherbrand J D, Tolani M, Calmette C, Moukhtar M S, Fournier A

出版信息

Proc Eur Dial Transplant Assoc. 1979;16:649-55.

PMID:44916
Abstract

Nine uraemic patients not yet on dialysis received IV 1 microgram/kg/min of propranolol for 85 min after a priming dose of 1 mg. Fifteen days later six of them received IV 1.2 microgram/kg/min of metoprolol after a priming dose of 1.2 mg. Plasma concentrations of PTH and calcitonin decreased significantly with propranolol but not with metoprolol. No change was observed with either drug as regards plasma concentration of total and ionised Ca and PO4. Heart rate was decreased similarly with both drugs. We conclude that (i) propranolol acutely suppresses PTH and Calcitonin secretion in uraemic patients. This warrants further studies to assess its long term effects on the secretion of these hormones and on renal osteodystrophy; (ii) the contrast between the significant effect of propranolol and the lack of effect with metoprolol supports the concept that PTH and CT secretion are moderated through specific beta 2 receptors.

摘要

9名尚未进行透析的尿毒症患者在静脉注射1毫克首剂后,以每分钟1微克/千克的速度静脉输注普萘洛尔,持续85分钟。15天后,其中6名患者在静脉注射1.2毫克首剂后,以每分钟1.2微克/千克的速度静脉输注美托洛尔。普萘洛尔使血浆甲状旁腺激素(PTH)和降钙素浓度显著降低,但美托洛尔未产生此效果。两种药物对血浆总钙、离子钙和磷酸盐浓度均无影响。两种药物使心率下降的情况相似。我们得出结论:(i)普萘洛尔可急性抑制尿毒症患者的PTH和降钙素分泌。这值得进一步研究,以评估其对这些激素分泌及肾性骨营养不良的长期影响;(ii)普萘洛尔的显著效果与美托洛尔的无效形成对比,支持了PTH和降钙素分泌通过特定β2受体调节的观点。

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