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低肾素性原发性高血压的机制探讨

APPROACH TO THE MECHANISM OF "LOW-RENIN" ESSENTIAL HYPERTENSION

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【作者】 赵光胜; 李迪元; 孔德汶; 王政; 陈贤妙; 黄友文; 曹素玲; 庞庆祥;

【Author】 Zhao Guang-sheng, et, al Shanghai Institute of Hypertension, Shanghai Second Medical University

【机构】 上海第二医科大学; 上海第二医科大学 上海市高血压研究所; 上海市高血压研究所;

【摘要】 低肾素性原发性高血压可能属于特定的临床和病理生理类型。本文比较低PRA与非低PRA性EH组在快速静滴盐水1000ml前后血浆血压调控激素、红细胞膜阳离子转运功能和膜结构变化。发现低PRA性者:(1)在盐水前的PA明显较高:PRA/PA较低。(2)负荷盐水期的尿排Na和K较少、盐水后红细胞膜向外Na~+-K~+协同转运较低,均趋潴Na。(3)盐水后PA仍较高,PRA及PRA/PA均较低。认为低PRA性EH的特点之一是细胞内外潴Na;值得对其肾素-血管紧张素-醛固酮-ACTH-多巴胺能系统间关系失调机制作进一步探索。

【Abstract】 "Low Renin" essential hypertension seems to be an unique clinical and pathophysiological category. Thirteen cases (21%) were found to be this sub-type taking plasma renin activity PRA<0.2 ng/ml/h as standard in 48 male essential hypertensives (40—59 years of age). The hormones modulating blood-pressure, erythrocyte membrane cation transport functions and configuration patterns before and after rapid 1000 ml intravenous salineloading were compared between "Low-Renin" and non-"Low-Renin" groups. Results showed: (1) plasma aldosterone (PA) level was significantly higher, while PRA/PA was lower in "Low-Renin" group before saline-loading; (2) urinary sodium and potassium output was less during saline-loading, the erythrocyte outward sodium and potassum cotransport and PRA (PRB/PA) were lower after saline-loading tending to sodiumretention. One of the characteristics of "Low-Renin" group might be susceptible to sodium-retention inside and outside of the cell, and the mechanism among renin-anigiotension-aldosterone-ACTH-dopamine systems should be further explored.

  • 【文献出处】 上海医学 ,Shanghai Medical Journal , 编辑部邮箱 ,1989年07期
  • 【被引频次】3
  • 【下载频次】68
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