糖尿病性自主神经病变中的血浆肾素活性

Plasma renin activity in diabetic autonomic neuropathy.

作者信息

Campbell I W, Ewing D J, Anderton J L, Thompson J H, Horn D B, Clarke B F

出版信息

Eur J Clin Invest. 1976 Sep 10;6(5):381-5. doi: 10.1111/j.1365-2362.1976.tb00532.x.

DOI:10.1111/j.1365-2362.1976.tb00532.x

Abstract

Postural changes in plasma renin activity were studied in three groups of age and duration-matched male diabetics (potent, impotent and with postural hypotension) and in non-diabetic control subjects. Those diabetic subjects with postural hypotension due to automatic neuropathy had no increase in plasma renin activity to the erect posture whereas both the potent and impotent groups had similar plasma renin activity responses to the control subjects. There was a significant inverse correlation between the rise in plasma renin activity on standing and the postural drop in blood pressure (r = 0.476, P less than 0.01) but no correlation with other tests of autonomic reflex function such as the Valsalva manoeuvre and blood pressure response to sustained handgrip. The results suggested that the lesion responsible for the postural hypotension is in the efferent sympathetic pathway. However, neuropathy per se did not wholly explain the decreased postural plasma renin activity response. Diabetic nephropathy, with involvement of cells of juxtaglomerular apparatus, may also be implicated.

摘要

研究了三组年龄和病程匹配的男性糖尿病患者（性功能正常、性功能障碍和伴有体位性低血压）以及非糖尿病对照受试者血浆肾素活性的体位变化。那些因自主神经病变导致体位性低血压的糖尿病患者，站立后血浆肾素活性并未升高，而性功能正常组和性功能障碍组的血浆肾素活性反应与对照受试者相似。站立时血浆肾素活性的升高与体位性血压下降之间存在显著的负相关（r = 0.476，P < 0.01），但与其他自主神经反射功能测试，如瓦尔萨尔瓦动作和持续握力时的血压反应无关。结果表明，导致体位性低血压的病变位于传出交感神经通路。然而，神经病变本身并不能完全解释体位性血浆肾素活性反应的降低。累及肾小球旁器细胞的糖尿病肾病也可能与之有关。