Dimsdale J E, Ziegler M G
Department of Psychiatry, University of California San Diego, La Jolla.
Circulation. 1991 Apr;83(4 Suppl):II36-42.
Because of the complex physiology of the sympathetic nervous system, venous and urinary catecholamine levels in response to stressors may serve as approximations of sympathetic nervous system activity in the heart and vasculature. Furthermore, the sympathetic nervous system does not respond in a homogeneous fashion to stressors; instead, there is differential activation at various sites of the sympathetic nervous system. Despite these limitations, numerous studies document that peripheral venous samples reflect sympathetic nerve firing and are related to cardiovascular pathophysiology. Although arterial norepinephrine levels may be more sensitive than venous levels, venous levels do respond to stressors when attention is given to the time course of sampling, the imprecision of assays (and thus the requirement for larger sample sizes), and the selection of appropriate tasks. In addition to catecholamines, there are other compounds that may be used to index sympathetic nervous system responses to stressors. Chromogranin A, as measured in antecubital blood, responds to large-scale perturbations of the sympathetic nervous system but appears relatively insensitive to short-term behavioral challenge. In response to stressors, diastolic blood pressure is better predicted by plasma levels of renin than of norepinephrine.
由于交感神经系统生理功能复杂，应激源作用下静脉血和尿中儿茶酚胺水平可近似反映心脏和血管系统中交感神经系统的活动。此外，交感神经系统对应激源的反应并非均匀一致；相反，交感神经系统不同部位存在差异性激活。尽管存在这些局限性，但大量研究表明外周静脉样本能反映交感神经放电情况，且与心血管病理生理学相关。虽然动脉去甲肾上腺素水平可能比静脉水平更敏感，但如果注意采样的时间进程、检测的不精确性（因此需要更大样本量）以及选择合适的任务，静脉水平对应激源也会有反应。除了儿茶酚胺，还有其他化合物可用于指示交感神经系统对应激源的反应。在肘前静脉血中检测的嗜铬粒蛋白A，对交感神经系统的大规模扰动有反应，但对短期行为挑战相对不敏感。对应激源而言，血浆肾素水平比去甲肾上腺素水平能更好地预测舒张压。
