Nigawara K, Yagihashi Y, Kogawa T, Sugawara S, Kawamata A, Hitomi H, Tulachan Y, Funyu T, Terayama Y, Furusawa M, Morita S, Kido K, Tanaka T, Eba H
Nihon Naibunpi Gakkai Zasshi. 1980 Jan 20;56(1):47-56. doi: 10.1507/endocrine1927.56.1_47.
To study the secretion of adrenocortical steroids, the renin releasing test and the angiotensin II analog (1-Sar, 8-Ala-Angiotensin II) infusion test was performed on four subjects with primary aldosteronism. The plasma renin activities of these subjects in the preoperative state were rather low, without any response to the renin releasing test. Plasma aldosterone was, however, significantly high and showed a tendency to declineits value when the subject was in an upright position. In the preoperative state, all the subjects lacked any alterations in plasma renin activity throughout the angiotensin II analog infusion test. Though slight elevations were observed in the blood pressure of three subjects, there was no demonstrable change in plasma aldosterone. In the other subject, though blood pressure did not change, plasma aldosterone exhibited a remarkable rise as did progesterone, 11-deoxycorticosterone and corticosterone. From these data, it was suggested that in the latter subject the aldosterone secretion was sensitive to angiotensin in comparison with ACTH. Three weeks after the operation, it was observed that plasma aldosterone response decreased, while the response of plasma renin activity to the renin releasing test was normal. This is considered to be due to the diminished sensitivity of the glomerulosa of the nonadenomatous adrenal gland to angiotensin. The levels of 17 alpha-hydroxyprogesterone, 11-deoxycorticosterone and corticosterone were almost within the normal range in the pre- and postoperative state. The levels of plasma progesterone and 11-deoxycorticosterone, however, tended to be lower in the postoperative state compared with the preoperative state.
为研究肾上腺皮质类固醇的分泌情况,对4例原发性醛固酮增多症患者进行了肾素释放试验和血管紧张素II类似物(1- Sar,8- Ala -血管紧张素II)输注试验。这些患者术前的血浆肾素活性相当低,对肾素释放试验无任何反应。然而,血浆醛固酮显著升高,且当患者处于直立位时其值有下降趋势。在术前状态下,所有患者在整个血管紧张素II类似物输注试验中血浆肾素活性均无变化。虽然3例患者的血压有轻微升高,但血浆醛固酮无明显变化。在另一例患者中,尽管血压未改变,但血浆醛固酮与孕酮、11-脱氧皮质酮和皮质酮一样显著升高。根据这些数据,提示在后一例患者中,与促肾上腺皮质激素相比,醛固酮分泌对血管紧张素敏感。术后3周观察到,血浆醛固酮反应降低,而血浆肾素活性对肾素释放试验的反应正常。这被认为是由于非腺瘤性肾上腺皮质球状带对血管紧张素的敏感性降低所致。术前和术后17α-羟孕酮、11-脱氧皮质酮和皮质酮的水平几乎在正常范围内。然而,与术前状态相比,术后血浆孕酮和11-脱氧皮质酮水平有降低趋势。