Sleight P
Department of Cardiovascular Medicine, University of Oxford, John Radcliffe Hospital, Headington, United Kingdom.
Am J Med. 1988 Mar 11;84(3A):92-6. doi: 10.1016/0002-9343(88)90211-2.
Circulatory reflexes are important in effecting rapid distribution of blood flow and an adequate driving pressure during adjustment to the stress of exercise, posture change, and other environmental challenges. Their primary evolutionary role may be a response to the extreme stress of hemorrhage. Derangements of reflex control may lead to adverse effects on organ blood flow, particularly renal blood flow; adjustments appropriate for support of the circulation during hemorrhage may be inappropriate in congestive heart failure. The balance between one control system and another may be altered by disease. Arterial baroreflex control of the circulation is impaired in hypertension, but may be partially compensated by increased gain in cardiopulmonary reflexes. Changes in autonomic balance in acute myocardial ischemia may be important in the mechanism of sudden death. Physical training can favorably modify arterial baroreflex function and adds to the evidence in favor of active rehabilitation after infarction.
循环反射对于在适应运动、体位改变及其他环境挑战的应激过程中实现血流的快速分布和足够的驱动压力很重要。它们主要的进化作用可能是对出血的极端应激作出反应。反射控制的紊乱可能会对器官血流，尤其是肾血流产生不利影响；在出血期间适合维持循环的调节在充血性心力衰竭时可能并不合适。一种控制系统与另一种控制系统之间的平衡可能会因疾病而改变。高血压时，动脉压力感受器对循环的控制受损，但心肺反射增益增加可能会起到部分代偿作用。急性心肌缺血时自主神经平衡的改变在猝死机制中可能很重要。体育锻炼可有益地改善动脉压力感受器功能，这也进一步证明了心肌梗死后积极康复的益处。
