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急性轻度高钙血症或钙拮抗剂硝苯地平对正常人体心血管对去甲肾上腺素或血管紧张素II反应性的影响。

Effects of acute mild hypercalcemia or of the calcium antagonist nifedipine on cardiovascular responsiveness to norepinephrine or angiotensin II in normal humans.

作者信息

Beretta-Piccoli C, Bianchetti M G, Weidmann P, Boehringer K, Link L, Morton J J

出版信息

J Cardiovasc Pharmacol. 1982;4 Suppl 3:S306-12.

PMID:6184559
Abstract

Pressor doses of infused norepinephrine (NE) (mean pressure, +20 mm Hg) or angiotensin II (AII) (diastolic pressure, +20 mm Hg) and corresponding blood levels of NE or AII were assessed in 12 young normal subjects under basal conditions (study A), during slow calcium infusion (0.034 mg/kg/min) started 60 min previously (study C), and following 2 weeks of treatment with the Ca antagonist nifedipine, 50 mg/day (study D). Control values of blood pressure, 24-h urinary sodium, plasma NE, epinephrine, AII, and renin activity did not differ among the three studies. Plasma Ca was higher during study C than during studies A and D [10.7 +/- 0.8 (+/- SD) versus 9.1 +/- 0.3 mg/dl; p less than 0.01]. Plasma NE or AII levels obtained during NE or AII infusion as well as the pressor doses of AII were not modified by concomitant Ca infusion or following nifedipine. However, compared with basal conditions, the NE pressor dose tended to be decreased slightly during Ca infusion (106 +/- 71 versus 77 +/- 38 ng/kg/min; difference not significant) and was increased markedly following nifedipine (178 +/- 87 ng/kg/min; p less than 0.05). A control infusion of Ca alone (study B) during 120 min did not modify blood pressure or plasma renin and NE levels. Our observations suggest that in normal humans, inhibition of cellular Ca transport may predominantly affect the noradrenergic control mechanism, whereas angiotensinogenic cardiovascular regulation may be less dependent.

摘要

在12名年轻正常受试者中,于基础状态下(研究A)、在60分钟前开始缓慢输注钙(0.034mg/kg/分钟)时(研究C)以及在接受钙拮抗剂硝苯地平50mg/天治疗2周后(研究D),评估了输注去甲肾上腺素(NE)(平均血压升高20mmHg)或血管紧张素II(AII)(舒张压升高20mmHg)的升压剂量以及相应的NE或AII血药浓度。三项研究中血压、24小时尿钠、血浆NE、肾上腺素、AII和肾素活性的对照值无差异。研究C期间的血浆钙高于研究A和D期间[10.7±0.8(±标准差)对9.1±0.3mg/dl;p<0.01]。NE或AII输注期间获得的血浆NE或AII水平以及AII的升压剂量未因同时输注钙或硝苯地平治疗而改变。然而,与基础状态相比,钙输注期间NE升压剂量有轻微下降趋势(106±71对77±38ng/kg/分钟;差异无统计学意义),硝苯地平治疗后显著升高(178±87ng/kg/分钟;p<0.05)。单独输注钙120分钟(研究B)未改变血压、血浆肾素和NE水平。我们的观察结果表明,在正常人体内,细胞钙转运的抑制可能主要影响去甲肾上腺素能控制机制,而血管紧张素源性心血管调节可能依赖性较小。

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