肾胺酶与心房颤动的相关性研究

目的:探讨肾胺酶在心房颤动(房颤)的发生及发展中的作用。方法:按照房颤与否将208例患者分为房颤组和对照组,每组各104例;按照房颤类型将房颤组分为持续性房颤组(n=68)与阵发性房颤组(n=36)。收集各组受试者的一般资料及静脉血,测定血浆肾胺酶、总儿茶酚胺浓度,比较两组肾胺酶及儿茶酚胺浓度的差异,分析其与房颤之间的相关性。结果:房颤组肾胺酶浓度低于对照组(P<0.05);阵发性房颤组与持续性房颤组肾胺酶浓度的差异无统计学意义(P>0.05)。房颤组与对照组之间及阵发性房颤组和持续性房颤组之间总儿茶酚胺浓度无统计学差异(P>0.05)。房颤组左房内径组大于对照组(P<0.05),持续性房颤组左房内径大于阵发性房颤组(P<0.05)。相关性分析显示,肾胺酶浓度与儿茶酚胺浓度负相关(r=-0.167,P<0.05)、与左房内径负相关(r=-0.212,P<0.05),但肾胺酶浓度与收缩压、舒张压、心率之间无相关性(P>0.05);总儿茶酚胺浓度与心率(r=0.176,P<0.05)、左房内径正相关(r=0.188,P<0.05),但总儿茶酚胺与收缩压、舒张压之间无相关性(P>0.05)。二元Logistic回归分析显示,肾胺酶是房颤发生的保护因素(OR<1,P<0.05)。结论:肾胺酶可能参与房颤的发生,并改善心脏重构。

嗜铬细胞瘤/副神经节瘤患者血NSE水平与临床特征的关系

目的 研究血清神经元特异性烯醇化酶(NSE)与嗜铬细胞瘤/副神经节瘤(PPGL)临床特征的关系。方法 选取2019年1月至2022年12月诊断的501例PPGL患者,按照NSE正常(≤16.3 ng/mL)和NSE升高(>16.3 ng/mL)进行分组,比较两组临床特征的差别。结果 NSE升高组患者与NSE正常组相比,肿瘤原发灶直径更大(5.00 cm vs 4.60 cm),24 h尿去甲肾上腺素(NE),24 h尿多巴胺(DA)水平更高,出现转移病变的比例更高(31.6%vs 13.7%)(P<0.05)。NSE水平与肿瘤原发灶大小(r=0.131,P<0.05)、24 h尿NE水平(r=0.195,P<0.05)、24 h尿DA水平(r=0.119,P<0.05)成正相关。结论 在PPGL患者中,NSE水平与肿瘤大小、分泌功能以及是否发生转移相关。

左侧星状神经节吗啡后处理在心肌梗死后重塑中的调节作用

目的探讨左侧星状神经节(left stellate ganglion,LSG)吗啡后处理在心肌梗死(myocardial infarction,MI)后重塑中的调控作用。方法SD大鼠随机分为4组:假手术组(Sham组)、心肌梗死组(MI组)、MI+生理盐水组(Control组)和MI+吗啡后处理组(MI+Morphine组)。结扎冠状动脉左前降支构建大鼠心肌梗死(myocardial infarction,MI)模型,随后采用经皮后入路法给予吗啡到LSG周围。4周后超声检测大鼠心功能变化;Masson染色检测纤维化改变;Western blot检测CollagenⅠ、CollagenⅢ蛋白表达;RT-qPCR检测ANP和BNP的mRNA表达;免疫荧光检测μ阿片受体(μopioid receptor,μOR)在LSG的表达;ELISA法检测血浆和心肌组织中儿茶酚胺浓度。结果与Sham组相比,MI组大鼠心功能明显受损,心肌组织呈现纤维化改变,血浆和心肌组织中儿茶酚胺浓度明显增高。与Control组相比,MI+Morphine组减少MI后大鼠心肌纤维化胶原沉积,抑制心肌组织中ANP和BNP的表达,降低儿茶酚胺的浓度,改善MI大鼠的心功能。免疫荧光结果显示μOR在MI后LSG中有表达,并且在吗啡后处理后表达增高。结论本研究表明,LSG吗啡后处理在MI后重塑中有心肌保护作用,其机制可能与吗啡激动LSG中μOR,减少交感神经末梢儿茶酚胺释放有关。

Changes of serum thyroid hormone and plasma catecholamine of 16 th and 17 th Chinese Expeditioners in Antarctic environment

The serum thyroid hormone and plasma catecholamine were examined in 18 male and 2 female members of the Chinese Antarctic Expedition (who spent the 2000 or 2001 austral winter at the Great Wall Station) . The changes of serum thyroid hormone i. e. total thyroxine (TT4) and free T4 (FT4) , total triodothyronine (TT3) and freeT3 ( FT3 ) , thyroid stimulating hormone ( TSH ) and plasma catecholamine, including norepinephrine (NE) , epinephrine ( E) and dopamine ( DA ) , were investigated by Chemoluminescence Immunoassay (CLIA) and High Performance Liquid Chromatography with electrochemical detection (HPLC-ECD) . Samples were taken at different time; (1)1 day before departure to Antarctica (16th expedition 1999/12/ 09; 17th expedition 2000/12/06). (2) 1 day after returned to China after living 54 weeks in Antarctica ( 16th expedition 2000/12/25 ; 17th expedition 2001/12/25 ). Comparing the data of before departure and returned, results showed that there was a significant decrease in the contents of TT4 (P <0. 01) with no significant change in the content of TT3 , FT3 and FT4. It was also found that the content of TSH increased significantly (P <0. 001) ; No significant changes of plasma NE and DA were found but the content of E decreased significantly ( P < 0. 001) . The results indicated that the special Antarctic environment led to a restrain effect on the thyroid function and the level of plasma E in Antarctic expedition members. Both the thyroid and adrenal medulla system were associated in response to the Antarctic systemic stress.

急性心力衰竭患者血清儿茶酚胺表达水平及其临床检测价值

目的:探讨急性心力衰竭(AHF)患者血清儿茶酚胺表达水平及其临床检测价值。方法:选取AHF患者112例为AHF组,体检健康者54例为对照组。收集患者一般资料、心功能分级(NYHA分级)、超声检查指标[左室射血分数(LVEF)]以及实验室检查指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、血红蛋白(Hb)、白蛋白(ALB)、空腹血糖(FPG)、N末端B型脑利钠肽前体(NT-proBNP)]。比较两组血清儿茶酚胺[去甲肾上腺素(NE)、肾上腺素(E)]及心肌酶谱[乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)]水平。采用Pearson法分析血清儿茶酚胺与心肌酶谱水平的相关性。随访90 d,根据预后情况分为预后良好组(81例)和预后不良组(31例)。采用Logistic回归分析AHF患者90 d内预后的影响因素。结果:AHF组血清NE和E水平高于对照组(均P<0.05)。AHF组血清CK、CK-MB、LDH及AST高于对照组(均P<0.05)。Pearson相关性分析结果显示,AHF患者血清NE、E水平与CK、CK-MB、LDH以及AST水平呈正相关(均P<0.05)。预后不良组和预后良好组患者的年龄、NYHA分级、NT-proBNP、LVEF、NE、E、CK、CK-MB、LDH以及AST比较差异有统计学意义(均P<0.05)。年龄≥65岁、NT-proBNP≥5000 pg/ml、NE≥400 ng/L以及E≥100 ng/L是AHF患者90 d内预后的独立危险因素(均P<0.05)。结论:AHF患者外周血儿茶酚胺及心肌酶谱水平升高,且外周血儿茶酚胺与心肌酶谱水平有关,年龄、NT-proBNP、NE以及E是AHF患者90 d内预后的独立影响因素。

Determination of urine catecholamines and metanephrines by reversed-phase liquid chromatography-tandem mass spectrometry

The measurement of urine catecholamine and metanephrine concentrations is important for biochemical screening and diagnosis of pheochromocytoma.The goal of this work was to develop a simple liquid chromatography-tandem mass spectrometry(LC-MS/MS)method for determining catecholamines and metanephrines in urine to replace an existing liquid chromatographic method using electrochemical detection.Urine samples were prepared using Oasis weak-cation-exchange cartridges.The eluate was analyzed on an Agilent ZORBAX Eclipse Plus Phenyl-Hexyl column in 3 min.Adrenaline,noradrenaline,dopamine,metanephrine,normetanephrine,and their deuterated internal standards were monitored in positive electrospray ionization mode by multiple reaction monitoring(MRM).No evidence of ion suppression was observed.The assay was linear up to 5μmol/L for adrenaline,5μmol/L for noradrenaline,6.1μmol/L for dopamine,5.6μmol/L for metanephrine,and 34.6μmol/L for normetanephrine,with lower limits of quantification of 5,5,12,6 and 7nmol/L,respectively.The intra-day and inter-day precisions for all analytes ranged from 0.59%to 4.64%and1.98%to 4.80%,respectively.External quality assurance samples were assayed and showed excellent agreement with the target values.This simple method provides an improved assay for determining urine catecholamines and metanephrines.

Relationship between catecholamine level and gene polymorphism of β1 adrenergic receptor G1165C in children with EV71 infection in hand foot and mouth disease

Objective:To investigate the relationship between the levels of plasma adrenaline and norepinephrine and gene polymorphism of β1 adrenergic receptor G1165 C in children with enterovirus 71(EV71) infection in hand foot and mouth disease(HFMD). Methods:The polymerase chain reaction(PCR) was used to detect the expression of gene polymorphism of β1 adrenergic receptor G1165 C in vitro. The levels of plasma adrenaline and norepinephrine were measured by enzyme-linked immunosorbent assay(ELISA). Results:The plasma norepinephrine level of severe group was significantly higher than the mild group in children with EV71 infection in HFMD(P<0.05); however,the levels of plasma adrenalinein in two groups had no statistical differences(P>0.05); There was no significant difference in the distribution of β1 adrenergic receptor G1165 C genotype and allele between EV71 infection group and healthy control group(P> 0.05). Further analysis of EV71 infection group by dividing it into mild and severe groups showed that there was no significant difference in the distribution of genotype and allele between these two groups as well(P> 0.05). There was no significant difference in the levels of epinephrine and norepinephrine in different genotypes of EV71 infection group(P> 0.05),and in the levels of plasma epinephrine and norepinephrine in the mild and severe groups(P> 0.05). Conclusions:As the disease gets worse,the plasma norepinephrine level has a rising trend in children with EV71 infection in HFMD,which is an important indicator to evaluate the progress of the disease. However,the gene polymorphism of eptor G1165 C have no significant correlation,not only with the susceptibility and severit β1 adrenergic recy of EV71 infection in hand,foot and mouth disease,but also with the levels of catecholamine.

Capillary electrophoresis with direct chemiluminescence detection for the analysis of catecholamines in human urine

A rapid and sensitive method for the analysis of three catecholamines by capillary electrophoresis （CE） with direct chemiluminescence （CL） detection is described. The detection limits （S/N= 3） were 1.3 × 10^-8 g/mL for isoprenaline, 1.0 × 10^-8g/mL for epinephrine and 2.8 × 10^-8 g/mL for dopamine. The proposed method was successfully applied to the analysis of catecholamines in urine samples of cigarette smokers and nonsmokers. The results showed that there is a close relation between the release of dopamine in human body fluids and cigarette smoking/nonsmoking.

The role of DJ-1 complexes and catecholamine metabolism： relevance for familial and idiopathic Parkinson＇s disease

Autosomal recessive mutations in the PARK7 gene,which encodes for the protein DJ-1,result in a loss of function and are a cause of familial Parkinson’s disease（PD）,while increased wild-type DJ-1protein levels are associated with some forms of cancer.Several functions of DJ-1 have been described,with the greatest evidence indicating that DJ-1 is a redox-sensitive protein involved in the regulation of oxidative stress and cell survival.

EFFECTS OF ALFENTANIL AND ESMOLOL ON HEMODYNAMIC AND CATECHOLAMINE RESPONSE TO TRACHEAL INTUBATION

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Effect of Catecholamine on Central Serous Chorioretinopathy

The role of catecholamine (CA) in the pathogenesis and development of macular edema of central serous chorioretinopathy (CSC) was studied, and its relations with visual acuity were investigated Plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined in 30 consecutive eyes with CSC Central macular thickness analysis was done by RTA and all the data were compared with normal eyes and analyzed with SAS software package Plasma concentrations of E and NE were increased to (569±123) ng/L and (721±104) ng/L respectively in active CSC patients, significantly higher than those in normal subjects ( P< 0 01), and decreased to normal in convalescent stage RTA analysis revealed that the retinal thickness of CSC patients was increased at active and recovery stage as compared with normal subjects; and the plasma concentration of E was significantly correlated with central macular thickness( t =2 173, P< 0 05) Also, central macular thickness measured by RTA was significantly correlated with the visual acuity ( r = -0 8046 , P< 0 001) in CSC eyes RTA analysis might be useful to quantitatively detect and evaluate prognosis in CSC patients The plasma concentration of E, which was highly correlated with macular edema, might play an important role in the early damage and the pathogenesis of CSC

Modified monolithic silica capillary for preconcentration of catecholamines

Preconcentration of catecholamines by the modified monolithic silica in the capillary was investigated in this study. In order to achieve a microchip-based method for determining catecholamines in the saliva,the monolithic silica was fabricated in the capillary and the monolithic silica was chemically modified by on-column reaction with phenylboronate. Different modified methods were compared. The concentration conditions were optimized. This study indicates the applicability of the modified monolithic silica capillary when it was used to concentrate catecholamines.

Manganese toxicity in the central nervous system: Decreeing of catecholamine in rat’s brains

Manganese is an essential metal in human that functions in many enzymes. In contrast excessive exposure to Mn results in neurotoxicity. Accumulation of manganese damages central nervous system and causes Parkinson disease like syndrome called manganism. Mn neurotoxicity has been suggested to involve an imbalance in catecholamine neurotransmitters. It hypothesized that Mn can obstruct catecholamine synthesis pathway by inhibition of Tyrosine hydroxylase. Previous studies demonstrated that chronic and acute dose of Mn has different possible effects on catecholamine synthesis. It’s assumed that an acute dose of manganese can kill dopaminergic cells. Therefore, we focused the effect of Mn in catecholamine concentration on the rat’s brain by MnCl2 injection intraperitoneally and analyzed their brains after the time interval. This study used different acute doses in short time courses and different chronic doses at different exposing times to investigate which of them (exposing dose or time) is more important in Mn toxic effect. Measurement of catecholamine concentration performed by fluorescence assay in acidic and oxidant environment.

Roles of catecholamine related polymorphisms in hypertension

The objective of this review is to summarize current data obtained so far in catecholamine-essential hypertension(EH) relationships on a genetic basis. As the major elements driving the sympathetic system's actions, catecholamines modulate a variety of physiological processes and mutations related to the system. This could generate serious disorders, such as severe mental illnesses, stress-induced disorders, or impairedcontrol of blood pressure or motor pathways. EH is idiopathic, and the genetic basis of its causes and substantial interindividual discrepancies in response to different types of treatments are the focus of interest. Susceptibility to disease or efficacy of treatments are thought to reflect genomic variabilities among individuals. Therefore, outlining the available knowledge in functional genetic polymorphisms linked to EH will make the picture clearer and will help to establish future prospects in the field.

EFFECTS OF ELECTROACUPUNCTURE ON PLASMA CATECHOLAMINE AND ANGIOTENSION Ⅱ IN OPEN HEART SURGICAL PATIENTS UNDERGOING CARDIOPULMONARY BYPASS

To study the effects of electroacupuncture on sympathetic adrenomedullary(SA) system and renin angiotensin aldosterone (RAA) system in open heart surgical patients undergoing cardiopulmonary bypass (CPB), 30 patients with atrial septal defect were randomly divided into general anesthesia (GA) group, acupuncture anesthesia (AA) group and acupuncture with general anesthesia (AGA) group. Peripheral blood samples were taken before anesthesia and 30 min after CPB. The plasma concentrations of norepinephrine (NE), epinphrine (E) and angiotensinⅡ(AⅡ) were detected. Results: Plasma NE and E of post CPB increased significantly in GA group and AA group, but decreased significantly in AGA group. Plasma AⅡ of post CPB increased significantly in GA group, but no marked changes were found in AA group and AGA group. Conclusions: Acupuncture can improve the AⅡ response to cardiac surgery and CPB. AGA but not AA can inhibit the catecholamine (CA) response to cardiac surgery and CPB.

Gene Regulation of Catecholamine Biosynthetic Enzymes by Nitric Oxide in PC12 Cells

Nitric oxide (NO) regulates a wide range of physiological processes. Recent studies show that NO can regulate the release of catecholamines (CA) from the adrenal medulla. In the current study, the PC12 cell line was used to examine the effect of NO on the regulation of the CA biosynthetic enzymes: tyrosine hydroxylase (TH), dopamine-β-hydroxylase (DBH) and phenylethanolamine Nmethyltransferase (PNMT). Treatment of PC12 cells with the NO donor, sodium nitroprusside (SNP) for 6 hours significantly increased TH, DBH and PNMT mRNA levels. In addition, NO potentiates the regulation of gene expression of all three CA biosynthetic enzymes by glucocorticoids and cholinergic agonists. The signaling pathways involved in NO regulation of CA biosynthetic enzymes were investigated with the use of specific kinase activators and inhibitors, with results supporting a contributing role of PKA, PKC and PKG in SNP-mediated induction for all three CA genes (p < 0.01). In addition, inhibitors of transcription and translation inhibited SNP-mediated induction of all three genes (p < 0.001) suggesting that both transcriptional and translational mechanisms may be involved in CA gene regulation by NO. Results from this study show that in addition to regulating CA biosynthetic enzymes, NO can also potentiate cholinergic and glucocorticoid activation of CA genes.

Factors Affecting Catecholamines in Caregivers of Patients with De­mentia

Background:Caregivers of dementia patients have significantly higher levels of serum IL-6 and CRP compared to non-caregivers,and the ac­cumulation of everyday stressors reportedly promotes the induction of inflammatory markers.However,few studies have identified factors that affect catecholamine levels in caregivers who experience a combination of physical and mental stress from caregiving.Purpose:This study aimed to identify physical factors that impact catecholamine levels in caregivers of dementia patients.Methods:Participants were elderly caregivers living together with elderly Alzhei­mer’s-type dementia patients.We performed logistic regression analysis,with levels of adrenaline,noradrenaline,and dopamine(indicators of catecholamine)as dependent variables.Results:Caregiver BMI had a significant impact on adrenaline levels(OR:0.792;95%CI:0.654-0.960)and noradrenaline levels(OR:1.210;95%CI:1.009-1.451),whereas age had a significant impact on dopamine levels(OR:1.162;95%CI:1.019-1.324).Discussion:While caregiver BMI significantly impacted adrenaline and noradrenaline levels,the mechanism underlying these relationships is unclear.One possibility is that obesity(BMI)and a rise in sympathetic nerve activity contributed to hypertension.Our findings suggest that chronic stress in elderly caregivers may potentially impair the dopaminergic activation system in the brain.Conclusion:There is a need to identify factors which increase BMI in caregivers.Future studies aimed at gaining a better understanding of the lifestyle habits of caregiv­ers and intervention studies aimed at reducing their BMI are warranted.

CARDIAC RISK STRATIFICATION IN PATIENTS WITH CONGESTIVE HEART FAILURE:A CATECHOLAMINES-β-ADRENOCEPTOR-cAMP PATHWAY

Objective To investigate the stratification risk of catecholamines-β-adrenoceptor (β-AR)-cAMP pathway for cardiogenic death events in patients with congestive heart failure (CHF). Methods A total of 83 identified CHF patients with a baseline and follow-up plasma levels of norepinephrine (NE) and epinephrine (E), lymphocytes β-AR density (Bmax), and intralymphocyte cAMP content in peripheral blood were followed up. Major cardiogenic death events were registered. Results The period between the initial entry and the last follow-up measurement were 51±16 months, the total duration of clinical follow-up after the last measurement were 14±8 months. During follow-up, 39 patients died of cardiogenic (sudden death 17 patients, worsening heart failure 22 patients). Persistence of high NE, E, and cAMP from baseline to follow-up were confirmed as risk predicting factors of cardiovascular events. Persistence NE above 4.0 nmol/L, E above 3.5 nmol/L, and the intralymphocyte cAMP content above 3.5 pmd·mg-1·pro-1 from baseline to follow-up were significant adverse prognostic predictors. The major cardiogenic death events rates per 100 patients-years were 1.33 and 4.82 in patients with NE below and above 4.0 nmol/L (HR: 2.91; 95% CI: 1.08-7.33; P = 0.015); were 1.42 and 4.36 in the patients with E levels below and above 3.5 nmol/L (HR: 2.64; 95% CI: 1.02-6.41; P = 0.019); were 1.81 and 4.67 in the patients with the intralymphocyte cAMP content below and above 3.5 pmd·mg-1·pro-1 (HR: 2.79; 95% CI: 1.04-6.83; P = 0.017), but difference was not significant between the β-AR density below and above median. Conclusions Persistent increase in circulating catecholamines and intralymphocyte cAMP content may increase the long-term mortality in CHF patients.

脑卒中供者心脏的心肌损伤机制与临床研究进展

脑死亡供者心脏是目前心脏移植最主要的器官来源。脑死亡发生后会出现严重的血流动力学改变和一系列器官功能变化,进而造成组织器官的功能损害甚至丧失,尤其是心脏。神经系统和心血管系统的生理、病理生理之间存在密切联系和相互作用,脑卒中发生后,通过脑-心轴反应导致自主神经失调、神经内分泌紊乱和强烈而持续的炎症反应,引发交感风暴、儿茶酚胺风暴、炎症风暴等导致脑卒中所致心脏损伤。本文旨在对近年来有关脑卒中供者心脏心肌损伤的机制研究及其对心脏移植术后疗效和预后影响的相关研究进行综述,为临床实践和进一步研究提供参考。

EFFECT OF ACUPUNCTURE COMBINED WITH EPIDURAL ANESTHESIA ON PLASMA CATECHOLAMINE CONTENT IN CHOLECYSTECTOMY PATIENTS

Objective: To observe changes of plasma catecholamine (CA) level in patients experiencing cholecystectomy under acupuncture anesthesia combined with epidural administration of small dose of anesthetics. Methods: 33 cholecystectomy patients were randomly divided into acupuncture combined with epidural anesthesia (A) group (n=11), acupoint skin electrical stimulation combined with epidural anesthesia (B) group (n=11) and simple epidural anesthesia (C) group (n=11). Acupoints used were bilateral Zusanli (ST 36) and Neiguan (PC 6) and stimulated with parameters of frequency 2/15 Hz, intermittent waves, electric current 2～3 mA for group A and 13mA for group B. Extradural anesthetic administered was 1.5% Lidocaine 5 mL. Venous blood samples were collected one day before, during and 3 days after operation for detecting plasma NE, E and DA contents. Results: ① During operation, plasma NE of group A and B lowered in comparison with pre operation, particularly group A (P<0.01), while in group C, plasma NE level increased slightly; plasma E of group A and B increased significantly compared with pre operation (P< 0.01). Plasma DA in the 3 groups all raised during operation. ② Three days after operation, plasma NE, E and DA levels recovered basically in comparison with those of one day before operation. It indicates that acupuncture or acupoint skin electrical stimulation is capable of regulating sympathetic activity during epidural anesthesia. The anesthetic effect has a closer relation with changes of plasma NE level rather than changes of plasma E or DA levels. Conclusion: Acupuncture or acupoint surface electrical stimulation combined with epidural anesthesia may be of reducing or releasing surgical operation generated stress response during cholecystectomy.