Karlberg B E
Acta Med Scand Suppl. 1983;672:33-40. doi: 10.1111/j.0954-6820.1983.tb01611.x.
This survey discloses the main mechanisms regulating renin release from the kidneys. Stimulation or inhibition of renin at least during a normal sodium intake seems to depend mostly on the sympathetic nervous system and be mediated through beta 1-adrenoceptors. The suppression of renin release is maintained during long-term treatment with both selective (beta 1) and non-selective (beta 1 + beta 2)-adrenoceptor blocking drugs. The role of alpha-adrenoceptors on renin release is less clear, both stimulating and suppressive effects having been described after treatment with alpha 1-adrenoceptor blocking therapy (i.e. prazosin). In certain conditions, i.e. when renal vascular resistance is increased or renal perfusion pressure augmented, renal prostaglandins (PG) especially PGE2, may play an important part in renin release. Angiotensin II (A II) and aldosterone generally follow the shifts in renin release. Thus, a decrease in both A II and plasma aldosterone is seen during long-term treatment with beta-adrenoceptor-blockade and may contribute to the blood-pressure lowering effect of these drugs.
这项调查揭示了调节肾脏肾素释放的主要机制。至少在正常钠摄入情况下,肾素的刺激或抑制似乎主要取决于交感神经系统,并通过β1肾上腺素能受体介导。在长期使用选择性(β1)和非选择性(β1 + β2)肾上腺素能受体阻断药物治疗期间,肾素释放受到抑制。α肾上腺素能受体对肾素释放的作用尚不清楚,在用α1肾上腺素能受体阻断疗法(即哌唑嗪)治疗后,既有刺激作用也有抑制作用的描述。在某些情况下,即当肾血管阻力增加或肾灌注压升高时,肾前列腺素(PG)尤其是PGE2,可能在肾素释放中起重要作用。血管紧张素II(A II)和醛固酮通常随肾素释放的变化而变化。因此,在长期使用β肾上腺素能受体阻滞剂治疗期间,A II和血浆醛固酮均会降低,这可能有助于这些药物的降压作用。