原发性高血压患者对促肾上腺皮质激素给药的血流动力学反应。

Haemodynamic response to ACTH administration in essential hypertension.

Whitworth J A, Saines D, Andrews J, Sloman J G, Scoggins B A

Clin Exp Pharmacol Physiol. 1981 Sep-Oct;8(5):553-6. doi: 10.1111/j.1440-1681.1981.tb00766.x.

Abstract

The haemodynamic and volume response to ACTH administration was investigated in six patients with mild, untreated essential hypertension and two patients with Addison's disease on maintenance steroids. Blood pressure, heart rate and weight were recorded daily. Plasma volume (125I-HSA) and cardiac output (thermo-dilution) were measured during the control period and on the 5th day of ACTH treatment. 2. In the hypertensive subjects, mean arterial pressure rose from 94.3 +/- 2.2 to 105.7 +/- 2.8 mmHg on the 5th day of ACTH administration (P less than 0.02). Plasma volume rose from 29.8 +/- 2.2 to 34 +/- 2.2 ml/kg. Cardiac index increased from 2.85 +/- 0.21 to 3.32 +/- 0.14 l/min per m2 (P less than 0.05). Cardiac output rose from 5.81 +/- 0.69 to 6.72 +/- 0.59 l/min. Calculated total peripheral resistance, heart rate and body weight were unchanged. No such changes were seen in patients with Addison's disease. 3. The haemodynamic characteristics of ACTH in patients with mild untreated essential hypertension are similar to those in the experimental model of ACTH induced hypertension in sheep.

摘要

对6例未经治疗的轻度原发性高血压患者和2例接受维持性类固醇治疗的艾迪生病患者，研究了给予促肾上腺皮质激素（ACTH）后的血流动力学和容量反应。每日记录血压、心率和体重。在对照期及ACTH治疗第5天时，测量血浆容量（125I-人血清白蛋白）和心输出量（热稀释法）。2. 在高血压受试者中，给予ACTH第5天时，平均动脉压从94.3±2.2 mmHg升至105.7±2.8 mmHg（P<0.02）。血浆容量从29.8±2.2 ml/kg升至34±2.2 ml/kg。心脏指数从2.85±0.21 l/min·m²增至3.32±0.14 l/min·m²（P<0.05）。心输出量从5.81±0.69 l/min升至6.72±0.59 l/min。计算得出的总外周阻力、心率和体重无变化。艾迪生病患者未见此类变化。3. 未经治疗的轻度原发性高血压患者中ACTH的血流动力学特征与绵羊ACTH诱导高血压实验模型中的特征相似。