Folkow B, Di Bona G F, Hjemdahl P, Torén P H, Wallin B G
Hypertension. 1983 Jul-Aug;5(4):399-403. doi: 10.1161/01.hyp.5.4.399.
The relationship between plasma levels of norepinephrine (NE) and sympathetic neural activity is discussed with special reference to human primary hypertension. Since sympathetic discharge is differentiated, neural activity to a given target organ will contribute variably to plasma NE levels in different situations. Hemodynamically, early primary hypertension is often characterized by a mild defense reaction-like pattern with signs of increased sympathetic activity to the heart and vasoconstriction in the renal and splanchnic vascular beds. Although important hemodynamically, these organs seem to be of less importance as contributors to peripheral plasma NE levels. In contrast, muscle sympathetic activity and muscle vascular resistance is unchanged or reduced. Since this organ mass contributes importantly to plasma NE levels, especially in peripheral venous blood, it is not surprising that most patients with primary hypertension have normal NE levels. It is concluded that NE concentrations in forearm or mixed venous blood are unreliable indicators of sympathetic neural contributions to essential hypertension, tending to underestimate this element, and that regional measurements of NE overflow are needed for a reliable analysis.
本文特别参照人类原发性高血压，讨论了血浆去甲肾上腺素（NE）水平与交感神经活动之间的关系。由于交感神经放电具有差异性，在不同情况下，支配特定靶器官的神经活动对血浆NE水平的贡献各不相同。从血流动力学角度来看，早期原发性高血压通常表现为轻度防御反应样模式，其特征为对心脏的交感神经活动增强，以及肾和内脏血管床的血管收缩。尽管这些器官在血流动力学方面很重要，但它们对外周血浆NE水平的贡献似乎较小。相比之下，肌肉交感神经活动和肌肉血管阻力未发生变化或有所降低。由于该器官质量对血浆NE水平有重要贡献，尤其是在外周静脉血中，因此大多数原发性高血压患者的NE水平正常也就不足为奇了。研究得出结论，前臂或混合静脉血中的NE浓度并不能可靠地反映交感神经对原发性高血压的影响，往往会低估这一因素，因此需要进行NE溢出的区域测量才能进行可靠的分析。
