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硝普钠对血小板钙动员的抑制作用:原发性高血压患者对一氧化氮敏感性降低的证据。

Inhibition by nitroprusside of platelet calcium mobilization: evidence for reduced sensitivity to nitric oxide in essential hypertension.

作者信息

Woods J D, Edwards J S, Ritter J M

机构信息

Department of Clinical Pharmacology, United Medical School, Guy's Hospital, London, UK.

出版信息

J Hypertens. 1993 Dec;11(12):1369-73. doi: 10.1097/00004872-199312000-00008.

Abstract

OBJECTIVE

Although platelets from patients with moderate hypertension are abnormally sensitive to agonist-induced aggregation, their sensitivity to antagonists is not known. Nitric oxide (NO) is an endogenous antagonist of platelet function. The objective of this study was to determine whether platelet sensitivity to the inhibitory activity of sodium nitroprusside, a donor of NO, is abnormal in hypertension.

DESIGN AND METHODS

Untreated patients with uncomplicated essential hypertension (mean arterial pressure > 120 mmHg) were studied. The rise in cytosolic calcium in response to 9,11-deoxy-11 alpha, 9 alpha-epoxymethanoprostaglandin F2 alpha (U46619, a thromboxane mimetic) was measured in fura-2-loaded platelets from 20 patients and 15 normotensive healthy subjects. Inhibition by sodium nitroprusside was measured in a further group of 14 patients and 20 normotensive subjects.

RESULTS

Basal cytosolic calcium concentration and the rise in this parameter induced by U46619 were significantly greater in platelets from hypertensive patients than in those from normotensive controls. The mean half-maximal inhibitory concentration of nitroprusside to calcium mobilization induced by 3 mumol/l U46619 was 3.1-fold greater in platelets from hypertensive patients than in those from controls (95% confidence interval 1.6-6.0).

CONCLUSION

The sensitivity of platelets to nitroprusside is reduced in essential hypertension. This reduced sensitivity to NO might influence the risk of arterial thrombosis in hypertensives.

摘要

目的

尽管中度高血压患者的血小板对激动剂诱导的聚集异常敏感,但其对拮抗剂的敏感性尚不清楚。一氧化氮(NO)是血小板功能的内源性拮抗剂。本研究的目的是确定高血压患者血小板对NO供体硝普钠抑制活性的敏感性是否异常。

设计与方法

研究未经治疗的单纯原发性高血压患者(平均动脉压>120 mmHg)。在20例患者和15名血压正常的健康受试者用fura-2标记的血小板中,测量对9,11-脱氧-11α,9α-环氧甲烯前列环素F2α(U46619,一种血栓素类似物)反应的胞质钙升高情况。在另一组14例患者和20名血压正常的受试者中测量硝普钠的抑制作用。

结果

高血压患者血小板的基础胞质钙浓度以及U46619诱导的该参数升高显著高于血压正常的对照组。对于3 μmol/l U46619诱导的钙动员,硝普钠在高血压患者血小板中的平均半数最大抑制浓度比对照组高3.1倍(95%置信区间1.6 - 6.0)。

结论

原发性高血压患者血小板对硝普钠的敏感性降低。这种对NO敏感性的降低可能会影响高血压患者动脉血栓形成的风险。

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