Yamamoto T, Polinsky R J, Goldstein D S, Baucom C E, Kopin I J
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892, USA.
J Lab Clin Med. 1996 Nov;128(5):488-91. doi: 10.1016/s0022-2143(96)90045-1.
Plasma levels of norepinephrine (NE), dihydroxyphenylglycol (DHPG), dihydroxyphenylalanine (DOPA), dopamine (DA), and dihydroxyphenylacetic acid (DOPAC)--all of which are free catechols--and sulfoconjugated DA (DASO4) were determined in 14 normal subjects and 18 patients with neurogenic orthostatic hypotension caused by either multiple system atrophy (MSA) (n = 11) or pure autonomic failure (n = 7). All free catechols were normal in patients with MSA, whereas NE, DHPG, DA, and DOPAC levels were significantly lower in patients with pure autonomic failure. The levels of DA-SO4, however, did not statistically differ among the three groups. The different plasma levels of free catechols in MSA and pure autonomic failure are consistent with the view that peripheral sympathetic neurons are relatively preserved in MSA, whereas they are severely affected in pure autonomic failure. Because DASO4 does not appear to be affected in pure autonomic failure, it appears likely that this metabolite is derived mainly from non-neural sources, such as the gastrointestinal tract, rather than from the sympathoadrenomedullary system.
在14名正常受试者以及18名由多系统萎缩（MSA）（n = 11）或单纯自主神经功能衰竭（n = 7）引起的神经源性直立性低血压患者中，测定了去甲肾上腺素（NE）、二羟基苯乙二醇（DHPG）、二羟基苯丙氨酸（DOPA）、多巴胺（DA）和二羟基苯乙酸（DOPAC）（均为游离儿茶酚胺）以及硫酸结合型多巴胺（DASO4）的血浆水平。MSA患者的所有游离儿茶酚胺水平均正常，而单纯自主神经功能衰竭患者的NE、DHPG、DA和DOPAC水平显著降低。然而，三组患者的DA-SO4水平在统计学上并无差异。MSA和单纯自主神经功能衰竭患者游离儿茶酚胺的血浆水平不同，这与以下观点一致：外周交感神经元在MSA中相对保留，而在单纯自主神经功能衰竭中则受到严重影响。由于DASO4在单纯自主神经功能衰竭中似乎未受影响，因此这种代谢产物似乎主要来源于非神经来源，如胃肠道，而非交感肾上腺髓质系统。
