Grüninger U, Akert R, Hunkeler H, Wegmüller E, Weidmann P, Hodler J
Klin Wochenschr. 1979 Jul 15;57(14):731-9. doi: 10.1007/BF01477555.
In seven patients with uncomplicated essential hypertension the effects of an acute alpha-adrenergic blockade, alone and combined with a chronic beta-adrenergic blockade, on blood pressure, renal function as measured by standard clearance methods, plasma renin activity, and plasma aldosterone were evaluated. Acute alpha-adrenergic blockade with phentolamine (20 mg by intravenous infusion) significantly enhanced the antihypertensive effect of chronic beta-adrenergic blockade with slow-oxprenolol (160 mg/ day X 14 days) (- 14.5% verus - 7.4% for pulse pressure, - 12.4% versus - 6.0% for diastolic pressure, 2 alpha less than 0.05). Under combined adrenergic blockade renal plasma flow increased, glomerular filtration rate and filtration fraction decreased (2 alpha less than 0.05 each), whereas the fractional clearances of sodium, potassium, free water, and solute load remained unchanged. The activation of the renin-angiotensin-axis, elicited by alpha-adrenergic blockade alone, was suppressed by the preceding beta-adrenergic blockade. These findings demonstrate a favourable antihypertensive action of a combined blockade of alpha- und beta-adrenergic receptor sites without untoward side effects on renal function or the renin-angiotensin-axis.
在7例单纯性原发性高血压患者中，评估了急性α-肾上腺素能阻滞剂单独应用以及与慢性β-肾上腺素能阻滞剂联合应用时，对血压、采用标准清除方法测定的肾功能、血浆肾素活性和血浆醛固酮的影响。用酚妥拉明（静脉输注20mg）进行急性α-肾上腺素能阻滞，显著增强了用慢氧烯洛尔（160mg/天×14天）进行慢性β-肾上腺素能阻滞的降压效果（脉压分别为-14.5%对-7.4%，舒张压分别为-12.4%对-6.0%，P均小于0.05）。在联合肾上腺素能阻滞时，肾血浆流量增加，肾小球滤过率和滤过分数降低（P均小于0.05），而钠、钾、自由水和溶质负荷的分数清除率保持不变。单独α-肾上腺素能阻滞引起的肾素-血管紧张素轴激活，被预先的β-肾上腺素能阻滞所抑制。这些发现表明，联合阻滞α和β肾上腺素能受体部位具有良好的降压作用，且对肾功能或肾素-血管紧张素轴无不良副作用。
