人类颈动脉压力感受器和化学感受器的去神经支配

Denervation of carotid baro- and chemoreceptors in humans.

作者信息

Timmers Henri J L M, Wieling Wouter, Karemaker John M, Lenders Jacques W M

机构信息

Department of Internal Medicine, University Medical Centre Nijmegen, PO Box 9101, 6500 HB Nijmegen, The Netherlands.

出版信息

J Physiol. 2003 Nov 15;553(Pt 1):3-11. doi: 10.1113/jphysiol.2003.052415. Epub 2003 Oct 3.

Abstract

Experimental denervation in animals has shown that carotid baro- and chemoreceptors play an eminent role in maintaining blood pressure and blood gas homeostasis. Denervation of carotid sinus baro- and chemoreceptors in humans may occur as a complication of invasive interventions on the neck or after experimental surgical treatment in asthma. In this topical review, the short- and long-term effects of carotid baro- and chemoreceptor denervation on the control of circulation and ventilation in humans are discussed. Carotid baroreceptor denervation in humans causes a persistent decrease in vagal and sympathetic baroreflex sensitivity and an increase in blood pressure variability; however, carotid denervation does not lead to chronic hypertension. Therefore, although carotid baroreceptors contribute to short-term blood pressure control, other receptors are able to maintain normal chronic blood pressure levels in the absence of carotid baroreceptors. Conversely, carotid chemoreceptor denervation leads to permanent abolition of normocapnic ventilatory responses to hypoxia and reduced ventilatory responses to hypercapnia.

摘要

动物实验性去神经支配表明,颈动脉压力感受器和化学感受器在维持血压和血气稳态方面发挥着重要作用。人类颈动脉窦压力感受器和化学感受器的去神经支配可能作为颈部侵入性干预的并发症或哮喘实验性手术治疗后发生。在本专题综述中,讨论了颈动脉压力感受器和化学感受器去神经支配对人体循环和通气控制的短期和长期影响。人类颈动脉压力感受器去神经支配会导致迷走神经和交感神经压力反射敏感性持续降低以及血压变异性增加;然而,颈动脉去神经支配不会导致慢性高血压。因此,尽管颈动脉压力感受器有助于短期血压控制,但在没有颈动脉压力感受器的情况下,其他感受器能够维持正常的慢性血压水平。相反,颈动脉化学感受器去神经支配会导致对低氧的正常碳酸通气反应永久消失,并降低对高碳酸血症的通气反应。

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