Ratge D, Augustin R, Wisser H
Int J Artif Organs. 1983 Sep;6(5):255-60.
To assess the interaction between adrenergic activity and blood pressure regulation, plasma catecholamines (CA), plasma renin activity (PRA) and plasma aldosteron (PA) were measured in 66 normal subjects and 18 dialysis patients. Prior to dialysis, blood levels of free norepinephrine (NE), epinephrine (E) and PRA were normal, but total (free and conjugated) CA as well as PA were significantly elevated. There was a spectrum of response during hemodialysis. On an average mean arterial blood pressure (MAP) fell during the first two hours of treatment, concomitantly followed by an increase in mean NE level. Whereas PRA and PA were highest at the end of treatment, mean free NE returned promptly to predialysis values through the late dialysis period. Severe hypotensive episodes during dialysis were associated with a baroreceptor-mediated adrenergic stimulation. These results indicate a qualitatively normal reaction of dialysis patients to volume removal and the importance of the renin-angiotensin-system in maintaining blood pressure during dialysis.
为评估肾上腺素能活性与血压调节之间的相互作用，对66名正常受试者和18名透析患者测定了血浆儿茶酚胺（CA）、血浆肾素活性（PRA）和血浆醛固酮（PA）。透析前，游离去甲肾上腺素（NE）、肾上腺素（E）和PRA的血水平正常，但总（游离和结合）CA以及PA显著升高。血液透析期间存在一系列反应。平均而言，在治疗的前两小时平均动脉血压（MAP）下降，随之平均NE水平升高。而PRA和PA在治疗结束时最高，平均游离NE在透析后期迅速恢复到透析前值。透析期间的严重低血压发作与压力感受器介导的肾上腺素能刺激有关。这些结果表明透析患者对容量清除存在定性正常的反应，以及肾素-血管紧张素系统在透析期间维持血压中的重要性。
