Brown R D, Wisgerhof M, Jiang N S, Kao P, Hegstad R
J Clin Endocrinol Metab. 1981 May;52(5):1014-8. doi: 10.1210/jcem-52-5-1014.
We performed this study to determine whether metoclopramide increases the concentration of plasma aldosterone in normal man by increasing the secretion rate of aldosterone or by decreasing aldosterone metabolic clearance. On the first day that metoclopramide was administered orally to seven normal subjects, the secretion rate of aldosterone increased significantly (P less than 0.05) from the rate during the preceding placebo period. By the fourth day of treatment, the secretion rate had returned to control values and remained there during an ensuing placebo period. The excretion rate of aldosterone followed a similar pattern. The increase in aldosterone secretion was accompanied by a transient but significant decrease in urinary sodium excretion. Metoclopramide administered iv had no effect on the metabolic clearance of aldosterone. Metoclopramide stimulated aldosterone-producing adenomas and nodular hyperplastic adrenal tissue resected from patients with primary aldosteronism to produce aldosterone in vitro. We conclude that metoclopramide increases the concentration of aldosterone in plasma by stimulating the secretion of aldosterone rather than by decreasing aldosterone metabolic clearance, and that metoclopramide probably stimulates aldosterone secretion by acting directly on adrenal tissue.
我们开展这项研究，以确定甲氧氯普胺是通过增加醛固酮分泌率还是降低醛固酮代谢清除率来提高正常男性血浆醛固酮浓度。在对7名正常受试者口服甲氧氯普胺的第一天，醛固酮分泌率较前一安慰剂期显著增加（P<0.05）。到治疗第4天，分泌率已恢复至对照值，并在随后的安慰剂期保持该水平。醛固酮排泄率呈现类似模式。醛固酮分泌增加的同时，尿钠排泄出现短暂但显著的减少。静脉注射甲氧氯普胺对醛固酮的代谢清除率无影响。甲氧氯普胺可刺激从原发性醛固酮增多症患者切除的醛固酮分泌性腺瘤和结节性增生肾上腺组织在体外分泌醛固酮。我们得出结论，甲氧氯普胺通过刺激醛固酮分泌而非降低醛固酮代谢清除率来提高血浆醛固酮浓度，且甲氧氯普胺可能通过直接作用于肾上腺组织来刺激醛固酮分泌。
