Nicholls M G, Espiner E A, Ikram H, Maslowski A H, Lun S, Scandrett M S
J Clin Endocrinol Metab. 1981 Jun;52(6):1253-6. doi: 10.1210/jcem-52-6-1253.
Potassium and angiotensin II are major regulators of aldosterone secretion. To assess which of these stimuli is the more potent, we measured aldosterone, potassium, and angiotensin II responses to the oral converting enzyme inhibitor captopril in five patients with resistant congestive heart failure during digoxin and furosemide maintenance therapy. In spite of a positive cumulative potassium balance and a clear-cut rise in plasma potassium, aldosterone levels in plasma and urine declined in parallel with levels of angiotensin II. When captopril treatment was later withdrawn in three patients, angiotensin II and aldosterone levels increased in parallel, while plasma potassium remained steady. The results show that under these study conditions, angiotensin II is more potent than potassium in regulating aldosterone in patients with heart failure.
钾和血管紧张素II是醛固酮分泌的主要调节因子。为了评估这些刺激因素中哪一种更具效力，我们在5例接受地高辛和速尿维持治疗的顽固性充血性心力衰竭患者中，测量了口服转换酶抑制剂卡托普利后醛固酮、钾和血管紧张素II的反应。尽管钾呈正性累积平衡且血浆钾明显升高，但血浆和尿液中的醛固酮水平与血管紧张素II水平平行下降。后来在3例患者中停用卡托普利治疗时，血管紧张素II和醛固酮水平平行升高，而血浆钾保持稳定。结果表明，在这些研究条件下，血管紧张素II在调节心力衰竭患者醛固酮方面比钾更具效力。
