Adrenergic activity and peripheral hemodynamics in relation to sodium sensitivity in patients with essential hypertension.
Adrenergic activity and peripheral hemodynamics in relation to sodium sensitivity in patients with essential hypertension.
复制标题
原发性高血压患者的肾上腺素能活性和外周血流动力学与钠敏感性相关。
作者：
M. Koolen;P. van Brummelen
在25例门诊高血压患者中，研究了钠敏感性与血浆去甲肾上腺素(NE)水平、去甲肾上腺素(NE)释放及静脉注射去甲肾上腺素(NE)的升压反应之间的关系。用体积描记仪测定前臂血流量(FBF)。有两个控制期，一个是研究开始时的4周控制期，另一个是研究结束时的2周控制期。差值范围为+18~-8 mm Hg。DeltaMAP>10 mm Hg的8例患者为盐敏感者。与盐不敏感者相比，盐敏感者在控制期(p<0.05)和摄入HS后2周(p<0.01)血浆NE水平较高。钠敏感性与血浆NE在HS和LS期间的变化直接相关(p<0.001)。在LS和HS期间，盐不敏感者NE释放减少，而盐敏感者NE释放增加。NE释放的变化与钠敏感性直接相关(p<0.05)。钠摄入量的变化对去甲肾上腺素的升压反应无明显影响。在LS和HS期间，盐敏感患者的FBF下降，盐不敏感患者的FBF增加。钠敏感性与前臂血管阻力的变化直接相关(p<0.01)。
In 25 outpatients with essential hypertension, sodium sensitivity, defined as the difference in mean arterial pressure (delta MAP) between 2 weeks of high-sodium (300 mmol per day) and 2 weeks of low-sodium (LS) intake (50-100 mmol per day), was studied in relation to the plasma norepinephrine (NE) level, NE release, and pressor response to intravenous NE. In addition, forearm blood flow (FBF) was measured by plethysmography. There were two control periods of regular sodium intake, one of 4 weeks' duration at the beginning of the study and one of 2 weeks' duration at the end. The delta MAP ranged from +18 to -8 mm Hg. The eight patients in whom delta MAP was greater than 10 mm Hg were regarded as salt-sensitive. When compared with salt-insensitive subjects, salt-sensitive patients had higher plasma NE levels in the control period (p less than 0.05) and after 2 weeks of HS intake (p less than 0.01). Sodium sensitivity was directly related to the change in plasma NE between the HS and LS periods (p less than 0.001). The NE release decreased in salt-insensitive subjects whereas it increased in salt-sensitive patients between the LS and HS periods. Changes in NE release were directly related to sodium sensitivity (p less than 0.05). The pressor response to NE was not significantly influenced by changes in sodium intake. The FBF fell in salt-sensitive patients and increased in salt-insensitive subjects between the LS and HS periods. Sodium sensitivity was directly related to the change in forearm vascular resistance (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)