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[高血压中的交感神经过度活跃]

[Sympathetic hyperactivity in hypertension].

作者信息

Takahashi Hakuo

机构信息

Department of Clinical Sciences Laboratory Medicine, Kansai Medical University.

出版信息

Nihon Rinsho. 2008 Aug;66(8):1495-502.

Abstract

It has been suggested that sympathetic hyperactivity is found in patients with metabolic syndrome (MS) by measuring turnover rate of catecholamines and/or muscle sympathetic nerve firing rate. Increased leptin associated with MS stimulates sympathetic outflow from the hypothalamus, which may be one of causes of sympathetic hyperactivity. Insulin increased in association with insulin resistant in MS increases sodium reabsorption in the kidney leading to sodium retention. Increased intra-cranial sodium ions are known to augment sympathetic nervous system activity via stimulation of epithelial sodium channels, mineralocorticoid receptors, the renin-angiotensin-aldosterone system and endogenous digitalislike factors in the brain. This mechanism may be true in patients with essential hypertension, particularly in those who are sensitive to sodium loading.

摘要

有人提出,通过测量儿茶酚胺的周转率和/或肌肉交感神经放电率,可发现代谢综合征(MS)患者存在交感神经过度活跃的情况。与MS相关的瘦素增加会刺激下丘脑的交感神经输出,这可能是交感神经过度活跃的原因之一。MS中与胰岛素抵抗相关的胰岛素增加会导致肾脏对钠的重吸收增加,从而导致钠潴留。已知颅内钠离子增加会通过刺激脑内上皮钠通道、盐皮质激素受体、肾素-血管紧张素-醛固酮系统和内源性洋地黄样因子来增强交感神经系统的活动。这种机制在原发性高血压患者中可能是成立的,尤其是那些对钠负荷敏感的患者。

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