PLASMA NOREPINEPHRINE PHARMACOKINETICS DURING MENTAL CHALLENGE
PLASMA NOREPINEPHRINE PHARMACOKINETICS DURING MENTAL CHALLENGE
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DOI：
10.1097/00006842-198711000-00004
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发表时间：
1987-11-01
影响因子：
3.3
通讯作者：
KOPIN, IJ
中科院分区：
文献类型：
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作者：
GOLDSTEIN, DS;EISENHOFER, G;KOPIN, IJ
我们同时向14名受试者静脉注射示踪剂标记的去甲肾上腺素（NE）和异丙肾上腺素（ISO），以测量静息时前臂和全身的去甲肾上腺素药代动力学以及对智力挑战（视频游戏或认知任务）的反应。精神挑战与心率（24%）、收缩压（13%）、心输出量（阻抗心电图，9%）、前臂血流量（38%）和内源性NE向动脉血中的释放率（全身NE溢出，29%）显著增加相关，但与肘前静脉NE的变化无关。全身NE外溢的反应与心输出量（n = 0.68）和收缩压（r = 0.60）的变化直接相关，而肘前静脉NE外溢的反应与此无关。前臂NE提取量与静息时（r = -0.80）和智力挑战时（r = -0.81）前臂血流量呈负相关，NE总清除率与静息时（r = 0.78）和智力挑战时（r = 0.54）心输出量呈正相关。结果表明，智力挑战与交感神经介导的NE释放普遍增加有关，而NE释放决定了血流动力学反应。由于心理应激时交感神经活动和血流的局部变化，枕前静脉NE甚至动脉NE的变化可能不能准确反映交感神经活动。全身和局部NE药代动力学的测量避免了这些困难。
We simultaneously infused tracer-labeled norepinephrine (NE) and isoproterenol (ISO) intravenously into 14 subjects to measure forearm and total body NE pharmacokinetics at rest and in response to mental challenge (video game or cognitive task). Mental challenge was associated with significantly increased heart rate (24%), systolic blood pressure (13%), cardiac output (impedance cardiography, 9%), forearm blood flow (38%), and the rate of release of endogenous NE into arterial blood (total body NE spillover, 29%), but not with changes in antecubital venous NE. Responses of total body NE spillover were directly related to changes in cardiac output (n = 0.68) and systolic blood pressure (r = 0.60), whereas those of antecubital venous NE were not. Forearm extraction of NE was related inversely to forearm blood flow both at rest (r = -0.80) and during mental challenge (r = -0.81), and total body clearance of NE was positively related to cardiac output at rest (r = 0.78) and during mental challenge (r = 0.54). The results indicate that mental challenge is associated with generally increased sympathetically-mediated NE release that determines the hemodynamic responses. Because of regional changes in sympathetic activity and blood flow during psychological stress, changes in antecubital venous NE and even arterial NE may not reflect accurately sympathetic nerve activity. Measurement of total body and regional NE pharmacokinetics avoids these difficulties.