普萘洛尔治疗期间的肾血流量和去甲肾上腺素分泌

Renal blood flow and noradrenaline secretion during treatment with propranolol.

de Leeuw P W, Punt R, Birkenhäger W H

Clin Sci (Lond). 1980 Dec;59 Suppl 6:477s-478s. doi: 10.1042/cs059477s.

Abstract

Fifty-five patients with uncomplicated essential hypertension were admitted to hospital, where 25 of them were treated with propranolol (average daily dose 240 mg) and 30 were left untreated. 2. In all of them renal arteriography was carried out, after which procedure renal plasma flow ([125I]hippuran clearance), cortical blood flow (xenon washout) and renal noradrenaline release were measured. 3. Compared with the untreated hypertensive patients, responders to propranolol (mean blood pressure less than or equal to 110 mmHg) during treatment showed enhanced cortical blood flow and reduced noradrenaline secretion. Non-responders had reduced cortical flow rates, but increased noradrenaline secretion. 4. Both in the untreated group and in the propranolol-treated group an inverse relationship between arterial noradrenaline concentration and cortical blood flow was found. 5. The results indicate that sympathetic activity may be an important determinant of renal blood flow in hypertension. The effectiveness of propranolol seems to depend upon a reduction in alpha-adrenergic tone.

摘要

55例单纯性原发性高血压患者入院，其中25例接受普萘洛尔治疗（平均日剂量240毫克），30例未接受治疗。2. 对所有患者进行了肾动脉造影，之后测量了肾血浆流量（[125I]马尿酸清除率）、皮质血流量（氙清除法）和肾去甲肾上腺素释放量。3. 与未治疗的高血压患者相比，治疗期间对普萘洛尔有反应者（平均血压小于或等于110毫米汞柱）皮质血流量增加，去甲肾上腺素分泌减少。无反应者皮质血流速率降低，但去甲肾上腺素分泌增加。4. 在未治疗组和普萘洛尔治疗组中均发现动脉去甲肾上腺素浓度与皮质血流量呈负相关。5. 结果表明，交感神经活动可能是高血压患者肾血流量的重要决定因素。普萘洛尔的疗效似乎取决于α-肾上腺素能张力的降低。