A decreased metabolic clearance rate of aldosterone in benign essential hypertension.
A decreased metabolic clearance rate of aldosterone in benign essential hypertension.
复制标题
良性原发性高血压中醛固酮代谢清除率降低。
DOI：
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发表时间：
1971
影响因子：
15.9
通讯作者：
J. Genest
中科院分区：
文献类型：
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作者：
W. Nowaczynski;O. Kuchel;J. Genest
测定了16例良性、无并发症的高血压病患者的醛固酮分泌率、代谢清除率和/或血药浓度，并与正常对照组进行比较。10例患者的平均醛固酮代谢清除率(P<；0.001)(平均867L/d/m(2)+/-270SD)明显低于7例健康人(平均1480L/d/m(2)+/-265SD)。13名患者(包括上述10名患者)的分泌率往往较低(83+/-43比109+/-54毫克/天)，而血浆浓度往往较高(13.6+/-4.6比7.5+/-4.8毫克/100毫升)，但这些差异均无统计学意义。即使在分泌速度正常或较低的情况下，较低的代谢清除率也可以解释血浆中醛固酮浓度升高的原因。因此，仅测量分泌率或尿液排泄量不足以确定高醛固酮增多症的存在和/或演变模式。醛固酮分泌不能完全适应降低的醛固酮代谢清除率(MCR)可以解释良性高血压患者的相对醛固酮增多症的状态，即使在分泌率和尿排泄率在正常范围内也是如此。
Aldosterone secretion rate, metabolic clearance rate, and/or plasma concentration were determined in 16 patients with benign, uncomplicated essential hypertension and compared with those of control subjects. The mean metabolic clearance rate of aldosterone in 10 patients was significantly (P < 0.001) lower (mean 867 liters of plasma/day per m(2) +/-270 SD) than in a group of 7 healthy subjects (mean 1480 liters/day per m(2) +/-265 SD). Secretion rates in 13 patients (including the 10 already mentioned) tended to be low (83 +/-43 vs. 109 +/-54 mug/day) and plasma concentrations tended to be high (13.6 +/-4.6 vs. 7.5 +/-4.8 ng/100 ml), but neither of these differences was statistically significant. The lower metabolic clearance rate could account for elevated plasma concentrations of aldosterone even when the secretion rate is normal or low. Measurement of secretion rate or urinary excretion only is therefore insufficient to establish the presence and/or mode of evolution of hyperaldosteronism. Failure of the aldosterone secretion to adapt fully to a decreased aldosterone metabolic clearance rate (MCR) could explain the state of relative hyperaldosteronism in patients with benign essential hypertension, even when the secretion rate and the urinary excretion rate are in the normal range.