Cryer P E, Haymond M W, Santiago J V, Shah S D
N Engl J Med. 1976 Sep 9;295(11):573-7. doi: 10.1056/NEJM197609092951101.
We studied the effects of cigarette smoking, sham smoking and smoking during adrenergic blockade in 10 subjects to determine whether smoking released the sympathetic neurotransmitter norepinephrine, as well as the adrenomedullary hormone epinephrine, and whether smoking-associated hemodynamic and metabolic changes were mediated through adrenergic mechanisms. Smoking-associated increments in mean (+/- S.E.M.) plasma norepinephrine (227 +/- 23 to 324 +/- 39 pg per milliliter, P less than 0.01) and epinephrine (44 +/- to 113 +/- 27 pg per milliliter, P less than 0.05) were demonstrated. Smoking-associated increments in pulse rate, blood pressure, blood glycerol and blood lactate/pyruvate ratio were prevented by adrenergic blockade; increments in plasma growth hormone and cortisol were not. Since significant smoking-associated increments, in pulse rate, blood pressure and blood lactate/pyruvate ratio, preceded measurable increments in plasma catecholamine concentrations, but were adrenergically mediated, these changes should be attributed to norepinephrine released locally from adrenergic axon terminals within the tissues rather than to increments in circulating catecholamines.
我们对10名受试者进行了研究，观察吸烟、假吸烟以及在肾上腺素能阻滞期间吸烟的影响，以确定吸烟是否会释放交感神经递质去甲肾上腺素以及肾上腺髓质激素肾上腺素，以及与吸烟相关的血流动力学和代谢变化是否通过肾上腺素能机制介导。结果显示，吸烟后血浆去甲肾上腺素平均水平（±标准误）从227±23 pg/ml增至324±39 pg/ml（P<0.01），肾上腺素从44±增至113±27 pg/ml（P<0.05）。肾上腺素能阻滞可阻止吸烟相关的脉搏率、血压、血甘油及血乳酸/丙酮酸比值升高；但不能阻止血浆生长激素和皮质醇升高。由于在血浆儿茶酚胺浓度出现可测量的升高之前，吸烟相关的脉搏率、血压和血乳酸/丙酮酸比值就已显著升高，且这些变化由肾上腺素能介导，因此这些变化应归因于组织内肾上腺素能轴突终末局部释放的去甲肾上腺素，而非循环儿茶酚胺的增加。
