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高血压患者交感神经对心脏受体刺激的反应受损。

Impaired responses of sympathetic nerves to cardiac receptor stimulation in hypertension.

作者信息

Thames M D

出版信息

Hypertension. 1987 May;9(5):478-84. doi: 10.1161/01.hyp.9.5.478.

Abstract

We recently reported that the vagal cardiopulmonary baroreceptor reflex inhibition of renal nerve traffic is impaired in rabbits with renal hypertension. The purpose of this study was to determine if the locus of the abnormality is mainly in the brain or in the afferent limb of the reflex. Experiments were done in alpha-chloralose-anesthetized rabbits with (n = 10) or without (n = 10) hypertension induced 6 to 8 weeks before study by wrapping the left kidney in cellophane followed by removal of the right kidney. The left side of the chest was opened, and a pericardial cradle was made. Nicotine was applied to the epicardial surface of the heart in concentrations of 10 to 500 micrograms/ml, and changes in arterial pressure and renal nerve traffic were measured. Dose-dependent decreases in traffic and arterial pressure resulted that were significantly smaller in hypertensive than in normotensive rabbits. After sinoaortic baroreceptor denervation, a similar impairment in the responses of hypertensive rabbits was observed. Vagotomy nearly abolished the responses of the renal nerves to epicardial nicotine. The responses of the lumbar sympathetic nerves to epicardial nicotine also were impaired in renal hypertensive (n = 8) compared with normotensive rabbits (n = 8). If the behavior and number of chemically sensitive endings are assumed to be unaltered in hypertension, then these findings are explained best by an abnormality in the central nervous system. These results support the view that the previously reported impairment in the vagal cardiopulmonary baroreceptor reflex control of renal nerve traffic is due mainly to a central abnormality, although they do not exclude an abnormality in the afferent limb of the reflex.

摘要

我们最近报道,肾性高血压兔迷走神经心肺压力感受器对肾神经活动的反射性抑制受损。本研究的目的是确定异常部位主要在脑还是在反射的传入支。实验在α-氯醛糖麻醉的兔身上进行,其中10只在研究前6至8周通过用玻璃纸包裹左肾并切除右肾诱导高血压,另10只未诱导高血压。打开左侧胸腔,制作心包托。将浓度为10至500微克/毫升的尼古丁应用于心脏的心外膜表面,测量动脉血压和肾神经活动的变化。结果发现,肾神经活动和动脉血压呈剂量依赖性下降,高血压兔的下降幅度明显小于正常血压兔。在切断窦主动脉压力感受器后,观察到高血压兔的反应也有类似损伤。迷走神经切断术几乎消除了肾神经对心外膜尼古丁的反应。与正常血压兔(n = 8)相比,肾性高血压兔(n = 8)腰交感神经对心外膜尼古丁的反应也受损。如果假设高血压时化学敏感末梢的行为和数量未改变,那么这些发现最好用中枢神经系统异常来解释。这些结果支持这样一种观点,即先前报道的迷走神经心肺压力感受器对肾神经活动的反射控制受损主要是由于中枢异常,尽管它们不排除反射传入支存在异常。

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