Kuchel O, Buu N T, Bourque M, Hamet P, Larochelle P
J Clin Endocrinol Metab. 1982 Jun;54(6):1268-70. doi: 10.1210/jcem-54-6-1268.
Two patients with adrenomedullary hypersecretion (confirmed pheochromocytoma and adrenomedullary hyperplasia) presented 15 spontaneous crises associated with hypertension or hypotension with or without tachycardia. Correlation coefficients calculated between extreme values of pulse rates and of systolic and diastolic blood pressures on the one hand and plasma free and conjugated norepinephrine, epinephrine, and dopamine (DA) sampled at the height of the crises on the other, showed no relationships between free or conjugated norepinephrine or epinephrine and blood pressure or pulse rate. However, plasma conjugated DA was negatively correlated with systolic blood pressures (P less than 0.02) and diastolic blood pressures (P less than 0.03) and free plasma DA was negatively correlated with pulse rates (P less than 0.001). These data suggest that the extremely high circulating level of conjugated DA in pheochromocytoma may, in the presence of high circulating conjugated norepinephrine and possibly high alpha-adrenergic receptor occupancy, decrease blood pressure by its predominant action on dopaminergic receptors while elevated free DA may decrease the tendency to tachycardia, possibly by lowering the venous return.
两名患有肾上腺髓质分泌亢进（确诊为嗜铬细胞瘤和肾上腺髓质增生）的患者出现了15次与高血压或低血压相关的自发性危象，伴有或不伴有心动过速。一方面，在危象高峰期测得的脉搏率、收缩压和舒张压的极值与另一方面采集的血浆游离和结合去甲肾上腺素、肾上腺素及多巴胺（DA）之间计算得出的相关系数显示，游离或结合的去甲肾上腺素或肾上腺素与血压或脉搏率之间无相关性。然而，血浆结合DA与收缩压呈负相关（P<0.02），与舒张压呈负相关（P<0.03），而游离血浆DA与脉搏率呈负相关（P<0.001）。这些数据表明，在嗜铬细胞瘤中，结合DA的循环水平极高，在结合去甲肾上腺素循环水平高且可能α-肾上腺素能受体占有率高的情况下，其对多巴胺能受体的主要作用可能会降低血压，而游离DA升高可能会降低心动过速的倾向，可能是通过降低静脉回心血量实现的。
