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内源性阿片肽和心脏传入神经对清醒家兔出血期间肾神经活动的影响。

Influence of endogenous opiates and cardiac afferents on renal nerve activity during haemorrhage in conscious rabbits.

作者信息

Burke S L, Dorward P K

机构信息

Baker Medical Research Institute, Melbourne, Australia.

出版信息

J Physiol. 1988 Aug;402:9-27. doi: 10.1113/jphysiol.1988.sp017191.

Abstract
  1. We investigated the effects of the opiate antagonist naloxone on changes in renal nerve activity and the renal sympathetic baroreflex during haemorrhage and whether they could be mimicked by blocking afferent input from cardiac receptors. 2. Renal nerve activity, arterial pressure and heart rate were recorded in conscious rabbits during blood loss of either 18 or 34-40% of the blood volume. The renal sympathetic baroreflex was elicited by perivascular balloon-induced changes in arterial pressure, before and at the end of haemorrhage. The experiment was repeated during intravenous naloxone infusion (4 mg kg-1, then 0.12 mg kg-1 min-1), and after blocking afferent input from cardiac receptors (5% intra-pericardial procaine). 3. Moderate haemorrhage elicited a rise in renal nerve activity and modest inhibition of the range of the renal sympathetic baroreflex. Severe haemorrhage triggered an abrupt fall in nerve activity and arterial pressure which was accompanied by strong inhibition of the baroreflex range and other curve parameters. There were minimal changes in the baroreceptor-heart rate reflex. 4. Intravenous naloxone and pericardial procaine prevented the falls in renal nerve activity and pressure triggered by severe blood loss but did not affect the increase in activity elicited by moderate haemorrhage. Both drugs produced similar enhancement of the normovolaemic renal sympathetic baroreflex. Naloxone prevented the baroreflex inhibition elicited by both levels of haemorrhage while pericardial procaine prevented most (but not all) of the baroreflex inhibition seen during severe haemorrhage without affecting that found during moderate haemorrhage. 5. We conclude that cardiac receptors (probably ventricular baroreceptors) but not arterial baroreceptors have an opiate synapse on their reflex pathways to the renal nerve. A major part of the action of naloxone during haemorrhage can be explained by blockade of this type of synapse on baroreflex pathways to renal and probably other sympathetic vasoconstrictors. The presence of procaine-resistant but naloxone-sensitive effects during haemorrhage suggests a role for extra-cardiac baroreceptors with opioid central nervous connections.
摘要
  1. 我们研究了阿片类拮抗剂纳洛酮对出血期间肾神经活动变化及肾交感压力反射的影响,以及阻断心脏感受器的传入输入是否能模拟这些影响。2. 在清醒家兔失血达血容量的18%或34 - 40%期间,记录肾神经活动、动脉血压和心率。在出血前及出血结束时,通过血管周围气囊诱导动脉血压变化来引发肾交感压力反射。在静脉输注纳洛酮(4毫克/千克,然后0.12毫克/千克·分钟)期间以及阻断心脏感受器的传入输入(心包内注射5%普鲁卡因)后重复该实验。3. 中度出血引起肾神经活动增加以及肾交感压力反射范围的适度抑制。重度出血引发神经活动和动脉血压突然下降,同时伴有压力反射范围及其他曲线参数的强烈抑制。压力感受器 - 心率反射变化极小。4. 静脉注射纳洛酮和心包内注射普鲁卡因可防止重度失血引发的肾神经活动和血压下降,但不影响中度出血引起的活动增加。两种药物对正常血容量时的肾交感压力反射均有类似增强作用。纳洛酮可防止两种程度出血引起的压力反射抑制,而心包内注射普鲁卡因可防止重度出血期间出现的大部分(但非全部)压力反射抑制,且不影响中度出血时的压力反射抑制。5. 我们得出结论,心脏感受器(可能是心室压力感受器)而非动脉压力感受器在其至肾神经的反射通路上有阿片类突触。出血期间纳洛酮的主要作用可通过阻断压力反射通路至肾及可能其他交感缩血管神经的此类突触来解释。出血期间存在对普鲁卡因耐药但对纳洛酮敏感的效应,提示心外压力感受器与阿片类中枢神经连接起作用。

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