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输注卡托普利对处于不同钠平衡状态的正常犬血压及肾素-血管紧张素-醛固酮系统的影响。

Effect of infused captopril on blood pressure and the renin-angiotensin-aldosterone system in normal dogs subjected to varying sodium balance.

作者信息

Morton J J, Tree M, Casals-Stenzel J

出版信息

Am J Cardiol. 1982 Apr 21;49(6):1395-400. doi: 10.1016/0002-9149(82)90349-6.

Abstract

Infusion of captopril at 20, 200, 2,000 and 6,000 micrograms/kg/hour into sodium-depleted conscious dogs produced a rapid, dose-dependent decrease in blood pressure and plasma angiotensin II and III, maximal suppression being achieved at 200 micrograms/kg/hour (97 +/- 14 to 65 +/- 8 [standard deviation] mm Hg, 38 +/- 10.6 to 3.2 +/- 1.5 pmol/liter and 7.0 +/- 4.8 to 1 +/- 0.5 pmol/liter, respectively). Angiotensin I concentration increased with each infusion rate to a maximal 16-fold increase at 6,000 micrograms/kg/hour (26 to 416 pmol/liter). For all infusion rates the percentage decrease in blood pressure correlated with the percentage decrease in plasma angiotensin II (r = 0.65, p less than 0.001). Infusion of captopril at 6,000 micrograms/kg/hour into sodium-loaded dogs also produced a decrease in both blood pressure (117 +/- 9 to 96.6 +/- 11 mm Hg) and plasma angiotension II (11.0 +/- 3 to 1.6 +/- 1.3 pmol/liter). Plasma aldosterone concentrations decreased whereas both blood angiotensin I and renin concentration increased. In another experiment angiotensin II was infused at 2, 6, 18 and 54 ng/kg/min into sodium-depleted dogs firstly without modification and secondly combined with captopril (6,000 micrograms/kg/hour) given for 1 hour before the angiotensin dose-response study and continued throughout. Angiotensin II infusion raised mean arterial pressure and plasma angiotensin II in each animal. However, the angiotensin II blood pressure dose-response curve was shifted downwards and to the right in the captopril-treated animals. These results suggest that arterial pressure and aldosterone secretion in normal dogs are partly dependent on the renin-angiotensin system but that not all of the acute decrease in blood pressure produced by captopril can be explained by the suppression of the acute vasoconstrictor effect of circulating angiotensin II.

摘要

以20、200、2000和6000微克/千克/小时的剂量向缺钠清醒犬输注卡托普利,可使血压、血浆血管紧张素II和III迅速出现剂量依赖性降低,在200微克/千克/小时时达到最大抑制效果(血压从97±14降至65±8[标准差]毫米汞柱,血浆血管紧张素II从38±10.6降至3.2±1.5皮摩尔/升,血浆血管紧张素III从7.0±4.8降至1±0.5皮摩尔/升)。血管紧张素I浓度随每次输注速率升高,在6000微克/千克/小时时最大升高16倍(从26升至416皮摩尔/升)。对于所有输注速率,血压下降百分比与血浆血管紧张素II下降百分比相关(r = 0.65,p<0.001)。以6000微克/千克/小时的剂量向钠负荷犬输注卡托普利,也可使血压(从117±9降至96.6±11毫米汞柱)和血浆血管紧张素II(从11.0±3降至1.6±1.3皮摩尔/升)降低。血浆醛固酮浓度降低,而血浆血管紧张素I和肾素浓度升高。在另一项实验中,首先在未作处理的情况下,然后在进行血管紧张素剂量反应研究前1小时给予卡托普利(6000微克/千克/小时)并持续给药,以2、6、18和54纳克/千克/分钟的剂量向缺钠犬输注血管紧张素II。血管紧张素II输注使每只动物的平均动脉压和血浆血管紧张素II升高。然而,在接受卡托普利治疗的动物中,血管紧张素II血压剂量反应曲线向下和向右移动。这些结果表明,正常犬的动脉压和醛固酮分泌部分依赖于肾素-血管紧张素系统,但卡托普利引起的血压急性降低并非全部都能通过抑制循环血管紧张素II的急性血管收缩作用来解释。

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