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清醒兔急性心脏压塞时肾神经活动双相反应的机制

Mechanism of biphasic response of renal nerve activity during acute cardiac tamponade in conscious rabbits.

作者信息

Hagiike M, Maeta H, Murakami H, Okada K, Morita H

机构信息

Department of Surgery, Kagawa Medical University School of Medicine, Kagawa 761-0793, Japan.

出版信息

Am J Physiol. 1999 May;276(5):R1232-40. doi: 10.1152/ajpregu.1999.276.5.R1232.

Abstract

Renal sympathetic nerve activity (RSNA) responses to acute cardiac tamponade were studied in conscious rabbits with all reflexes intact (Int) or after either surgical sinoaortic denervation (SAD) or administration of intrapericardial procaine (ip-Pro) or intravenous procaine (iv-Pro). In Int rabbits, the mean arterial pressure (MAP) remained relatively constant until the pericardial volume reached 7. 7 ml, whereas the RSNA increased to 226% [compensated cardiac tamponade (CCT)], then, at a pericardial volume of 9.3 ml, the MAP fell sharply and RSNA decreased to 34% [decompensated cardiac tamponade (DCT)]; 1 min after cessation of pericardial infusion, an intravenous injection of naloxone resulted in increases in both MAP and RSNA. In SAD rabbits, RSNA did not alter throughout CCT and DCT, but increased on injection of naloxone. In ip-Pro rabbits, RSNA increased during CCT but did not decrease during DCT, whereas, in iv-Pro rabbits, the RSNA response was similar to that in Int rabbits. These results indicate that RSNA responses to cardiac tamponade are biphasic, with an increase during CCT and a decrease during DCT. Sinoaortic baroreceptors are involved in mediating the increase in RSNA, whereas cardiac receptors may be involved in mediating the decrease in RSNA. An endogenous opioid may be responsible for the decrease in RSNA seen during DCT.

摘要

在清醒的家兔中研究了肾交感神经活动(RSNA)对急性心脏压塞的反应,这些家兔的所有反射均完整无损(Int组),或在进行了外科主动脉弓去神经支配(SAD)、心包内注射普鲁卡因(ip-Pro)或静脉注射普鲁卡因(iv-Pro)之后。在Int组家兔中,直到心包容积达到7.7 ml时,平均动脉压(MAP)保持相对恒定,而RSNA增加至226%[代偿性心脏压塞(CCT)],然后,在心包容积为9.3 ml时,MAP急剧下降,RSNA降至34%[失代偿性心脏压塞(DCT)];心包内输注停止1分钟后,静脉注射纳洛酮导致MAP和RSNA均升高。在SAD组家兔中,在整个CCT和DCT过程中RSNA没有变化,但注射纳洛酮后升高。在ip-Pro组家兔中,RSNA在CCT期间升高,但在DCT期间没有下降,而在iv-Pro组家兔中,RSNA反应与Int组家兔相似。这些结果表明,RSNA对心脏压塞的反应是双相的,在CCT期间增加,在DCT期间减少。主动脉弓压力感受器参与介导RSNA的增加,而心脏感受器可能参与介导RSNA的减少。内源性阿片类物质可能是导致DCT期间RSNA降低的原因。

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