Relationship between respiratory failure and plasma noradrenaline levels in amyotrophic lateral sclerosis
Relationship between respiratory failure and plasma noradrenaline levels in amyotrophic lateral sclerosis
复制标题
肌萎缩侧索硬化症呼吸衰竭与血浆去甲肾上腺素水平的关系
DOI：
10.1007/bf02267978
复制
发表时间：
1997
影响因子：
5.8
通讯作者：
Gen Sobue
中科院分区：
文献类型：
--
作者：
A. Yamashita;Yasuo Koike;Akira Takahashi;M. Hirayama;N. Murakami;Gen Sobue
我们对20例散发性肌萎缩侧索硬化症(ALS)患者在静息和直立倾斜试验中血浆去甲肾上腺素(NA)水平进行了评估。空腹血浆NA水平在195~4227 pg/ml之间，其中5例非卧床患者平均血浆NA水平为483pg/ml，2例轮椅患者平均血浆NA水平为341 pg/ml，11例卧床不起患者平均血浆NA水平为1264 pg/ml，2例呼吸机依赖患者平均血浆NA水平为208 pg/ml。动脉二氧化碳(PCO2)作为呼吸功能的指标进行评估。PCO2与血浆NA的相关系数r=0.654(P<0.01)。呼吸衰竭或下运动神经元功能障碍可能与血浆NA水平升高有关。在两名卧床不起的患者中，随着疾病的进展，血浆NA水平和静息心率显著增加。对仰卧位的心血管反应是正常的。这些数据表明，血浆NA水平的升高可能与呼吸衰竭的进展和运动神经元功能障碍的降低有关。总之，ALS的交感神经过度活动被认为不是原发的，而是继发于躯体运动障碍和呼吸衰竭。
We evaluated plasma noradrenaline (NA) levels at rest and during head-up tilt test in 20 patients with sporadic amyotrophic lateral sclerosis (ALS). Their fasting plasma NA levels ranged from 195 to 4227 pg/ml. The average plasma NA level was 483 pg/ml in five ambulatory patients, 341 in two wheelchair-bound patients, 1264 in 11 bedridden patients, and 208 in two respirator-dependent patients whose disability grading was the worst among the four groups. Arterial carbon dioxide (PCO2) was evaluated as a measure of respiratory function. The coefficient of correlation between PCO2and plasma NA wasr=0.654 (p<0.01). Either respiratory failure or lower motor neuron dysfunction may relate to the elevation of plasma NA levels. In the two bedridden patients, plasma NA levels and heart rate at rest increased significantly as the disease progressed. Cardiovascular responses to head-up tilting were normal. These data suggest that the elevation of plasma NA levels may be related to progression of respiratory failure and lower motor neuron dysfunction. In conclusion, sympathetic hyperactivity in ALS is considered to be not primary, but secondary to somatic motor disabilities and respiratory failure.