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运动诱导动脉血压升高期间交感神经激活的动脉压力感受器反射缓冲作用。

Arterial baroreflex buffering of sympathetic activation during exercise-induced elevations in arterial pressure.

作者信息

Scherrer U, Pryor S L, Bertocci L A, Victor R G

机构信息

Department of Internal Medicine, (Cardiology Division), Harry S. Moss Heart Center, University of Texas Southwestern Medical Center, Dallas 75235.

出版信息

J Clin Invest. 1990 Dec;86(6):1855-61. doi: 10.1172/JCI114916.

Abstract

Static muscle contraction activates metabolically sensitive muscle afferents that reflexively increase sympathetic nerve activity and arterial pressure. To determine if this contraction-induced reflex is modulated by the sinoaortic baroreflex, we performed microelectrode recordings of sympathetic nerve activity to resting leg muscle during static handgrip in humans while attempting to clamp the level of baroreflex stimulation by controlling the exercise-induced rise in blood pressure with pharmacologic agents. The principal new finding is that partial pharmacologic suppression of the rise in blood pressure during static handgrip (nitroprusside infusion) augmented the exercise-induced increases in heart rate and sympathetic activity by greater than 300%. Pharmacologic accentuation of the exercise-induced rise in blood pressure (phenylephrine infusion) attenuated these reflex increases by greater than 50%. In contrast, these pharmacologic manipulations in arterial pressure had little or no effect on: (a) forearm muscle cell pH, an index of the metabolic stimulus to skeletal muscle afferents; or (b) central venous pressure, an index of the mechanical stimulus to cardiopulmonary afferents. We conclude that in humans the sinoaortic baroreflex is much more effective than previously thought in buffering the reflex sympathetic activation caused by static muscle contraction.

摘要

静态肌肉收缩会激活代谢敏感的肌肉传入神经,从而反射性地增加交感神经活动和动脉血压。为了确定这种收缩诱导的反射是否受窦主动脉压力反射调节,我们在人体进行静态握力试验时,对静息腿部肌肉的交感神经活动进行了微电极记录,同时试图通过使用药物控制运动诱导的血压升高来钳制压力反射刺激水平。主要的新发现是,在静态握力过程中对血压升高进行部分药物抑制(输注硝普钠),会使运动诱导的心率和交感神经活动增加超过300%。对运动诱导的血压升高进行药物增强(输注去氧肾上腺素),会使这些反射性增加减弱超过50%。相比之下,这些对动脉血压的药物操作对以下方面几乎没有影响:(a) 前臂肌肉细胞pH值,这是对骨骼肌传入神经代谢刺激的一个指标;或(b) 中心静脉压,这是对心肺传入神经机械刺激的一个指标。我们得出结论,在人类中,窦主动脉压力反射在缓冲静态肌肉收缩引起的反射性交感神经激活方面比之前认为的要有效得多。

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