Scott E M, Greenwood J P, Gilbey S G, Stoker J B, Mary D A
Department of Cardiology, St. James's University Hospital, Leeds LS9 7TF, UK.
Clin Sci (Lond). 2001 Mar;100(3):335-42.
A marked pressor response to water drinking has been observed in patients with autonomic failure and in the elderly, and has been attributed to sympathetic vasoconstrictor activation, despite the absence of such a pressor response in healthy subjects with intact sympathetic mechanisms. We investigated whether water drinking in normal subjects affected peripheral sympathetic neural discharge and its effect on vascular resistance. In nine normal human subjects, we examined the effect of water ingestion on muscle sympathetic neural activity from the peroneal nerve, as multi-unit bursts (muscle sympathetic nerve activity; MSNA) and as single-unit impulses (s-MSNA) with vasoconstrictor function, and on calf vascular resistance for 120 min. In each subject, water ingestion caused increases in s-MSNA and MSNA which peaked at 30 min after ingestion; they increased respectively (mean+/-S.E.M.) from 42+/-4 to 58+/-5 impulses/100 beats (P<0.01) and from 36+/-4 to 51+/-5 bursts/100 beats (P<0.001). There were corresponding increases in calf vascular resistance and in plasma noradrenaline levels. A significant correlation occurred between all of these data. In conclusion, measurement of MSNA has provided direct evidence that water drinking in normal human subjects increases sympathetic nerve traffic, leading to peripheral vasoconstriction. This sympathetic activation was not accompanied by significant changes in arterial blood pressure.
在自主神经功能衰竭患者和老年人中观察到对饮水有明显的升压反应,且该反应被归因于交感缩血管神经激活,尽管具有完整交感神经机制的健康受试者不存在这种升压反应。我们研究了正常受试者饮水是否会影响外周交感神经放电及其对血管阻力的影响。在9名正常人类受试者中,我们检测了摄入水对来自腓神经的肌肉交感神经活动的影响,将其作为具有缩血管功能的多单位爆发(肌肉交感神经活动;MSNA)和单单位冲动(s-MSNA),并检测了120分钟内小腿血管阻力的变化。在每个受试者中,摄入水导致s-MSNA和MSNA增加,在摄入后30分钟达到峰值;它们分别(平均值±标准误)从42±4增加到58±5次冲动/100次心跳(P<0.01),从36±4增加到51±5次爆发/100次心跳(P<0.001)。小腿血管阻力和血浆去甲肾上腺素水平相应增加。所有这些数据之间存在显著相关性。总之,MSNA的测量提供了直接证据,表明正常人类受试者饮水会增加交感神经活动,导致外周血管收缩。这种交感神经激活并未伴有动脉血压的显著变化。