Goldberg L I
Am J Med. 1984 Oct 5;77(4A):37-44. doi: 10.1016/s0002-9343(84)80036-4.
The endogenous catecholamine dopamine lowers blood pressure by acting on two receptor subtypes: dopamine 1 and dopamine 2. Dopamine 1 receptors subserve vasodilation, especially in the renal, coronary, mesenteric, and cerebral vascular beds. Dopamine 2 receptors have been located at the endings of postganglionic sympathetic nerves and, when activated, inhibit norepinephrine release. Inhibition of emesis and inhibition of prolactin release also appear to be dopamine 2-mediated phenomena. The receptor subtypes have been classified by differences in chemical structure of agonists and by specific antagonists. Dopamine also acts on beta 1 receptors to stimulate the heart and alpha 1 and alpha 2 receptors to cause vasoconstriction. Alpha adrenergic activity and lack of oral availability limit the use of dopamine in the treatment of hypertension. However, studies with the selective dopamine 1 agonist, fenoldopam, and dopamine 2 agonists such as LY 141865 and bromocriptine, indicate that agonists of both receptor subtypes can lower blood pressure in experimental animals and in hypertensive patients. Initial use of dopamine agonists in the treatment of hypertension and its possible involvement in the etiology and maintenance of hypertension are discussed.
多巴胺1型和多巴胺2型。多巴胺1型受体有助于血管舒张，尤其是在肾、冠状动脉、肠系膜和脑血管床。多巴胺2型受体位于节后交感神经末梢，激活后会抑制去甲肾上腺素释放。抑制呕吐和抑制催乳素释放似乎也是多巴胺2介导的现象。受体亚型已根据激动剂的化学结构差异和特异性拮抗剂进行分类。多巴胺还作用于β1受体以刺激心脏，作用于α1和α2受体以引起血管收缩。α肾上腺素能活性和口服不可用性限制了多巴胺在高血压治疗中的应用。然而，对选择性多巴胺1激动剂非诺多泮以及多巴胺2激动剂如LY 141865和溴隐亭的研究表明，这两种受体亚型的激动剂均可降低实验动物和高血压患者的血压。本文讨论了多巴胺激动剂在高血压治疗中的初步应用及其可能在高血压病因和维持中的作用。
