Guyton A C
University of Mississippi Medical Center, Jackson.
Acta Physiol Scand Suppl. 1990;591:107-13.
The purpose of this paper has been to emphasize the extreme importance of the renal function curve in determining the long-term level of arterial pressure. The reason for this importance is that the renal-body fluid-pressure control system exhibits the phenomenon of "infinite feedback gain". This is, the arterial pressure will stabilize only when the intake and output of water and salt becomes exactly equal, and this occurs at only one very exact pressure level for any given renal function curve and given salt intake level. This renal mechanism for controlling the body fluids and simultaneously controlling the arterial pressure, because of its infinite feedback gain capability for controlling arterial pressure, requires that other pressure control mechanisms must interact with this mechanism either to alter the renal function curve or to make the animal change its intake of salt and water if the other pressure mechanisms are to have any effect on the long-term arterial pressure level. Therefore, in virtually any analysis of long-term arterial pressure regulation, the renal function curve or its mathematical equivalent plays a central role.
本文的目的在于强调肾功能曲线在决定动脉血压长期水平方面的极端重要性。这种重要性的原因在于肾-体液压力控制系统呈现出“无限反馈增益”现象。也就是说,只有当水和盐的摄入与排出恰好相等时,动脉血压才会稳定,而对于任何给定的肾功能曲线和给定的盐摄入水平,这仅在一个非常精确的压力水平上才会发生。这种控制体液并同时控制动脉血压的肾脏机制,由于其对动脉血压具有无限反馈增益能力,所以如果其他压力控制机制要对动脉血压的长期水平产生任何影响,就要求其他压力控制机制必须与该机制相互作用,要么改变肾功能曲线,要么使动物改变其水和盐的摄入量。因此,在几乎任何对长期动脉血压调节的分析中,肾功能曲线或其数学等效物都起着核心作用。