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颈动脉体化学感受器的紧张活动有助于原发性高血压中交感神经驱动的增加。

Tonic activity of carotid body chemoreceptors contributes to the increased sympathetic drive in essential hypertension.

机构信息

Department of Internal Medicine, Hypertension and Vascular Diseases, Medical University of Warsaw, Warsaw, Poland.

出版信息

Hypertens Res. 2012 May;35(5):487-91. doi: 10.1038/hr.2011.209. Epub 2011 Dec 8.

Abstract

Carotid chemoreceptors provoke an increase in muscle sympathetic nerve activation (MSNA) in response to hypoxia; they are also tonically active during normoxic breathing. The contribution of peripheral chemoreceptors to sympathetic activation in hypertension is incompletely understood. The aim of our study was to investigate the effect of chemoreceptor deactivation on sympathetic activity in untreated patients with hypertension. A total of 12 untreated hypertensive males and 11 male controls participated in this randomized, crossover, placebo-controlled study. MSNA, systolic blood pressure(BP), diastolic BP, heart rate (HR), electrocardiogram, hemoglobin oxygen saturation (Sat%) and respiratory movements were measured during repeated 10-min periods of respiration with 100% oxygen or 21% oxygen in a blinded fashion. Compared with controls, hypertensives had higher resting MSNA (38 ± 10 vs. 29 ± 0.9 burst per min, P<0.05), systolic BP (150 ± 12 vs. 124 ± 10 mm Hg, P< 0.001) and diastolic BP (92 ± 10 vs. 77 ± 9 mm Hg, P<0.005). Breathing 100% oxygen caused significant decrease in MSNA in hypertensive patients (38 ± 10 vs. 26 ± 8 burst per min and 100 ± 0 vs. 90 ± 10 arbitrary units, P<0.05) and no change in controls (29 ± 9 vs. 27 ± 7 burst per min and 100 ± 0 vs. 96 ± 11 arbitrary units). BP, respiratory frequency and end tidal CO(2) did not change during chemoreceptor deactivation with hyperoxia. HR decreased and Sat% increased in both the study groups. These results confirm the role of tonic chemoreceptor drive in the development of sympathetic overactivity in hypertension.

摘要

颈动脉化学感受器在缺氧时引发肌肉交感神经激活(MSNA)增加;在正常氧合呼吸期间它们也处于紧张活动状态。外周化学感受器对高血压患者交感神经激活的贡献尚未完全了解。我们的研究目的是探讨去化学感受器作用对未经治疗的高血压患者交感神经活性的影响。共有 12 名未经治疗的高血压男性和 11 名男性对照者参加了这项随机、交叉、安慰剂对照研究。在盲法条件下,通过重复的 10 分钟 100%氧气或 21%氧气呼吸期,测量 MSNA、收缩压(BP)、舒张压(BP)、心率(HR)、心电图、血红蛋白氧饱和度(Sat%)和呼吸运动。与对照组相比,高血压患者的静息 MSNA(38±10 比 29±0.9 爆发/分钟,P<0.05)、收缩压(150±12 比 124±10mmHg,P<0.001)和舒张压(92±10 比 77±9mmHg,P<0.005)更高。呼吸 100%氧气引起高血压患者 MSNA 显著降低(38±10 比 26±8 爆发/分钟和 100±0 比 90±10 任意单位,P<0.05),而对照组无变化(29±9 比 27±7 爆发/分钟和 100±0 比 96±11 任意单位)。去化学感受器作用期间,BP、呼吸频率和潮气末 CO2 无变化。在两个研究组中,HR 降低,Sat%升高。这些结果证实了紧张化学感受器驱动在高血压中交感神经过度活跃发展中的作用。

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