Watanabe E, Ogawa K, Ban M, Satake T
Jpn Circ J. 1981 Jun;45(6):646-53. doi: 10.1253/jcj.45.646.
Twenty-three patients with chronic respiratory failure and 30 normal subjects were studied to assess the sympathetic nervous activity in chronic hypoxic states, especially in chronic cor pulmonale. Of the 23 patients, 13 had a right ventricular hypertrophy (RVH) pattern on the electrocardiogram. Plasma norepinephrine (NE), dopamine-beta-hydroxylase (DBH), cyclic adenosine 3',5'-monophosphate (cyclic AMP) and cyclic guanosine 3',5'-monophosphate (cyclic GMP) concentrations were measured before and after oxygen inhalation. Plasma NE concentrations were 0.57 +/- 0.07 ng/ml in patients with chronic respiratory failure and 0.22 +/- 0.02 ng/ml in controls (p less than 0.001). Moreover, plasma NE concentrations were higher in patients with RVH than without (p less than 0.05), and these concentrations decreased significantly (p less than 0.05) in the former patients after oxygen inhalation. Plasma cyclic AMP concentrations were 31.2 +/- 2.6 pmol/ml in cases of chronic respiratory failure and 17.4 +/- 0.7 pmol/ml in controls (p less than 0.001) with no difference in plasma cyclic GMP and DBH concentrations. These results suggest that a significant proportion of patients with chronic respiratory failure, especially with cor pulmonale, were in hyper-adrenergic states partially due to hypoxia.
对23例慢性呼吸衰竭患者和30名正常受试者进行了研究，以评估慢性低氧状态下，尤其是慢性肺源性心脏病患者的交感神经活动。23例患者中，13例心电图显示有右心室肥厚（RVH）模式。在吸氧前后测量血浆去甲肾上腺素（NE）、多巴胺-β-羟化酶（DBH）、环磷酸腺苷（环AMP）和环磷酸鸟苷（环GMP）的浓度。慢性呼吸衰竭患者的血浆NE浓度为0.57±0.07 ng/ml，对照组为0.22±0.02 ng/ml（p<0.001）。此外，有RVH的患者血浆NE浓度高于无RVH的患者（p<0.05），吸氧后前者患者的这些浓度显著降低（p<0.05）。慢性呼吸衰竭患者的血浆环AMP浓度为31.2±2.6 pmol/ml，对照组为17.4±0.7 pmol/ml（p<0.001），血浆环GMP和DBH浓度无差异。这些结果表明，相当一部分慢性呼吸衰竭患者，尤其是肺源性心脏病患者，处于高肾上腺素能状态，部分原因是缺氧。
