Caballero Oliver A, Stiefel García-Junco P, García-Donas López M A, Villar Ortiz J, Carneado de la Fuente J
Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla.
Med Clin (Barc). 1995 Dec 8;105(20):768-73.
To characterize the possible existence of kinetic anomalies of four erythrocyte membrane sodium transport systems in a group of essential hypertensive patients, and to study the clinical and biochemical profile of those with anomalies.
We studied 33 essential hypertensive patients and 33 normotensive controls. The kinetics (maximal rate and apparent dissociation constant for internal sodium) of Na(+)-K+ pump, Na(+)-K(+)-Cl- cotransport and Na(+)-Li+ countertransport was calculated after a sodium loading procedure, according to the methods of Garay; the passive Na+ permeability was also determined.
The studied kinetic parameters were not significantly different in both groups. Nevertheless, we found a group of hypertensive patients with some transport abnormalities: increased intracellular sodium (9.1%), accelerated Na+ passive permeability (9.1%), lower activity of the Na(+)-K+ pump (7.1%) and the Na(+)-K(+)-Cl- cotransport (4%) and an increased maximal rate of the Na(+)-Li+ countertransport (11.8%). Na+Li+ countertransport activity was statistically related to plasma levels of urea, creatinine, glucose and LDL-cholesterol, and the activity of the Na(+)-K(+)-Cl- cotransport was related to plasma uric acid. The hypertensive patients with sodium transport anomalies showed higher body mass index, uric acid plasma levels and atherogenic index than those without these kind of anomalies, and they also showed lowered HDL-cholesterol plasma levels.
A small group of essential hypertensive patients (around 31%) show kinetic alterations of sodium transport systems. There is a relation between Na(+)-Li+ countertransport activity and some cardiovascular risk parameters. Hypertensive patients with transport anomalies are a group with an increased cardiovascular risk.
为了确定一组原发性高血压患者中四种红细胞膜钠转运系统是否可能存在动力学异常，并研究存在异常的患者的临床和生化特征。
我们研究了33例原发性高血压患者和33例血压正常的对照者。根据加雷的方法，在钠负荷程序后计算钠钾泵、钠钾氯协同转运和钠锂逆向转运的动力学（内部钠的最大速率和表观解离常数）；还测定了被动钠通透性。
两组研究的动力学参数无显著差异。然而，我们发现一组高血压患者存在一些转运异常：细胞内钠增加（9.1%）、钠被动通透性加快（9.1%）、钠钾泵活性降低（7.1%）和钠钾氯协同转运活性降低（4%）以及钠锂逆向转运的最大速率增加（11.8%）。钠锂逆向转运活性与血浆尿素、肌酐、葡萄糖和低密度脂蛋白胆固醇水平存在统计学关联，钠钾氯协同转运活性与血浆尿酸有关。存在钠转运异常的高血压患者的体重指数、血浆尿酸水平和致动脉粥样硬化指数高于无此类异常的患者，他们的血浆高密度脂蛋白胆固醇水平也较低。
一小部分原发性高血压患者（约31%）表现出钠转运系统的动力学改变。钠锂逆向转运活性与一些心血管风险参数之间存在关联。存在转运异常的高血压患者是心血管风险增加的一组人群。
