Jespersen B, Brock A, Charles P, Danielsen H, Sørensen S S, Pedersen E B
Department of Medicine and Nephrology C, Skejby Hospital, Denmark.
Scand J Clin Lab Invest. 1993 Aug;53(5):479-86. doi: 10.1080/00365519309092543.
In order to evaluate the role of the hyperparathyroid state for blood pressure and volume homeostasis, eight patients with primary hyperparathyroidism were studied before and after corrective surgery. Neither noradrenaline induced blood pressure changes nor basal blood pressure were affected by the operation, and the values were the same as in an age- and sex-matched control group. Noradrenaline infusion induced an increase in PTH(1-84) values before (72-86 ng l-1, medians, p < 0.02), in contrast to a decrease after (28 to 19 ng l-1, p < 0.05) operation for primary hyperparathyroidism. Basal plasma atrial natriuretic peptide was lower before than after removal of adenomata (3.2 vs. 4.8 pmol l-1, medians, p < 0.02). Cyclic 3'-5'-guanosine monophosphate was not significantly changed (4.7 vs. 5.5 nmol l-1). Aldosterone was higher before than after surgery (139 vs. 71 pmol l-1, p < 0.02), whereas angiotensin II was unaltered (20 vs. 9 pmol l-1). Arginine vasopressin was higher before than after the operation (0.9 vs. 0.7 pmol l-1, p < 0.05), but urinary excretion of prostaglandin E2 was unchanged. In conclusion primary hyperparathyroidism was not associated with changes in noradrenaline reactivity or basal blood pressure despite derangements of hormones adjusting sodium and water homeostasis. It is suggested that the hormonal changes may be secondary to a relative volume depletion.
为了评估甲状旁腺功能亢进状态在血压和容量稳态中的作用，对8例原发性甲状旁腺功能亢进患者在矫正手术前后进行了研究。去甲肾上腺素诱导的血压变化和基础血压均未受手术影响，其值与年龄和性别匹配的对照组相同。原发性甲状旁腺功能亢进患者术前静脉输注去甲肾上腺素后PTH(1 - 84)值升高（中位数为72 - 86 ng l-1，p < 0.02），而术后降低（28至19 ng l-1，p < 0.05）。基础血浆心钠素在腺瘤切除术前低于术后（中位数分别为3.2 vs. 4.8 pmol l-1，p < 0.02）。环磷酸鸟苷无显著变化（4.7 vs. 5.5 nmol l-1）。醛固酮术前高于术后（139 vs. 71 pmol l-1，p < 0.02），而血管紧张素II未改变（20 vs. 9 pmol l-1）。精氨酸加压素术前高于术后（0.9 vs. 0.7 pmol l-1，p < 0.05），但前列腺素E2的尿排泄未改变。总之，尽管调节钠和水平衡的激素紊乱，但原发性甲状旁腺功能亢进与去甲肾上腺素反应性或基础血压的变化无关。提示激素变化可能继发于相对的容量减少。
