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继发性高血压中肾脏对肾交感神经活动急性反射激活及肾去神经支配的反应。

Renal responses to acute reflex activation of renal sympathetic nerve activity and renal denervation in secondary hypertension.

作者信息

Evans Roger G, Burke Sandra L, Lambert Gavin W, Head Geoffrey A

机构信息

Department of Physiology, Monash University, Victoria 3800, Australia.

出版信息

Am J Physiol Regul Integr Comp Physiol. 2007 Sep;293(3):R1247-56. doi: 10.1152/ajpregu.00217.2007. Epub 2007 Jul 11.

DOI:10.1152/ajpregu.00217.2007
PMID:17626124
Abstract

We tested whether the responsiveness of the kidney to basal renal sympathetic nerve activity (RSNA) or hypoxia-induced reflex increases in RSNA, is enhanced in angiotensin-dependent hypertension in rabbits. Mean arterial pressure, measured in conscious rabbits, was similarly increased (+16 +/- 3 mmHg) 4 wk after clipping the left (n = 6) or right (n = 5) renal artery or commencing a subcutaneous ANG II infusion (n = 9) but was not increased after sham surgery (n = 10). Under pentobarbital sodium anesthesia, reflex increases in RSNA (51 +/- 7%) and whole body norepinephrine spillover (90 +/- 17%), and the reductions in glomerular filtration rate (-27 +/- 5%), urine flow (-43 +/- 7%), sodium excretion (-40 +/- 7%), and renal cortical perfusion (-7 +/- 3%) produced by hypoxia were similar in normotensive and hypertensive groups. Hypoxia-induced increases in renal norepinephrine spillover tended to be less in hypertensive (1.1 +/- 0.5 ng/min) than normotensive (3.7 +/- 1.2 ng/min) rabbits, but basal overflow of endogenous and exogenous dihydroxyphenolglycol was greater. Renal plasma renin activity (PRA) overflow increased less in hypertensive (22 +/- 29 ng/min) than normotensive rabbits (253 +/- 88 ng/min) during hypoxia. Acute renal denervation did not alter renal hemodynamics or excretory function but reduced renal PRA overflow. Renal vascular and excretory responses to reflex increases in RSNA induced by hypoxia are relatively normal in angiotensin-dependent hypertension, possibly due to the combined effects of reduced neural norepinephrine release and increased postjunctional reactivity. In contrast, neurally mediated renin release is attenuated. These findings do not support the hypothesis that enhanced neural control of renal function contributes to maintenance of hypertension associated with activation of the renin-angiotensin system.

摘要

我们测试了在兔血管紧张素依赖性高血压中,肾脏对基础肾交感神经活动(RSNA)或低氧诱导的RSNA反射性增加的反应性是否增强。在清醒兔中测量的平均动脉压,在夹闭左肾动脉(n = 6)或右肾动脉(n = 5)或开始皮下注射血管紧张素II(ANG II,n = 9)4周后同样升高(+16±3 mmHg),但在假手术(n = 10)后未升高。在戊巴比妥钠麻醉下,低氧引起的RSNA反射性增加(51±7%)和全身去甲肾上腺素溢出(90±17%),以及肾小球滤过率降低(-27±5%)、尿流量降低(-43±7%)、钠排泄降低(-40±7%)和肾皮质灌注降低(-7±3%),在正常血压组和高血压组中相似。低氧诱导的肾去甲肾上腺素溢出增加在高血压兔(1.1±0.5 ng/min)中往往低于正常血压兔(3.7±1.2 ng/min),但内源性和外源性二羟基苯乙二醇的基础溢出量更大。低氧期间,高血压兔(22±29 ng/min)的肾血浆肾素活性(PRA)溢出增加低于正常血压兔(253±88 ng/min)。急性肾去神经支配未改变肾血流动力学或排泄功能,但降低了肾PRA溢出。在血管紧张素依赖性高血压中,低氧诱导的RSNA反射性增加所引起的肾血管和排泄反应相对正常,这可能是由于神经去甲肾上腺素释放减少和节后反应性增加的联合作用。相比之下,神经介导的肾素释放减弱。这些发现不支持以下假设,即增强对肾功能的神经控制有助于维持与肾素-血管紧张素系统激活相关的高血压。

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