Zheng X, Zhang T, Ding H, Wang C
Department of Cardiology, Changhai Hospital, Shanghai, China.
Int J Cardiol. 1995 Oct;51(3):233-44. doi: 10.1016/0167-5273(95)02423-t.
In order to investigate the changes of endogenous opiate systems in hypertension and their possible role in the pathogenesis in hypertension, we measured plasma concentrations of beta-endorphin, leucine-enkephalin, neurotension, arginine vasopressin, plasma renin activity and angiotensin II by radioimmunoassay in 60 normal persons and 120 patients with essential hypertension. The results showed that the patient group had lower levels of beta-endorphin and leucine enkephalin (P < 0.001), higher levels of arginine vasopressin, plasma renin activity and angiotensin II (P < 0.01, P < 0.05 and P < 0.05, respectively), and normal level of neurotensin, as compared with those in normal group. Plasma levels of leucine-enkephalin was correlated negatively to the mean artery pressure (r = -0.196, P < 0.05). Plasma level of arginine vasopressin was correlated to the duration of the hypertension (r = 0.216, P < 0.05). After 150 min and 14 days of treatment with clonidine, plasma levels of beta-endorphin, leucine-enkephalin increased significantly (< 0.01) and correlated negatively with the decrease of the mean artery pressure (r = -0.340 and r = -0.436 at 150 min, r = -0.369 and r = -0.441 on the 14th day, respectively, P < 0.01). Plasma renin activity and angiotensin II decreased significantly (P < 0.05 and P < 0.01). Arginine vasopressin and neurotensin did not change significantly. After intravenous administration of opiate antagonist-naloxone, the blood pressure and heart rate increased significantly (P < 0.01). The results suggested that the changes of endogenous opioids may be involved in the pathogenesis of hypertension and in the antihypertensive action of clonidine.
为了研究高血压患者体内内源性阿片系统的变化及其在高血压发病机制中的可能作用，我们采用放射免疫分析法检测了60名正常人及120例原发性高血压患者血浆中β-内啡肽、亮氨酸脑啡肽、神经降压素、精氨酸血管加压素、血浆肾素活性及血管紧张素Ⅱ的浓度。结果显示，与正常组相比，患者组β-内啡肽和亮氨酸脑啡肽水平较低（P < 0.001），精氨酸血管加压素、血浆肾素活性及血管紧张素Ⅱ水平较高（分别为P < 0.01、P < 0.05和P < 0.05），神经降压素水平正常。血浆亮氨酸脑啡肽水平与平均动脉压呈负相关（r = -0.196，P < 0.05）。精氨酸血管加压素水平与高血压病程相关（r = 0.216，P < 0.05）。可乐定治疗150分钟及14天后，血浆β-内啡肽、亮氨酸脑啡肽水平显著升高（P < 0.01），且与平均动脉压的下降呈负相关（150分钟时r = -0.340和r = -0.436，第14天时r = -0.369和r = -0.441，P均 < 0.01）。血浆肾素活性及血管紧张素Ⅱ显著降低（P < 0.05和P < 0.01）。精氨酸血管加压素和神经降压素无显著变化。静脉注射阿片拮抗剂纳洛酮后，血压和心率显著升高（P < 0.01）。结果提示，内源性阿片类物质的变化可能参与高血压的发病机制及可乐定的降压作用。
