Kiowski W, Julius S
J Clin Invest. 1978 Sep;62(3):656-63. doi: 10.1172/JCI109173.
Plasma renin activity (renin) and hemodynamic response to venous pooling of blood in legs were studied in 24 healthy volunteers and four patients who after bilateral nephrectomy received a functioning renal transplant. Blood pressure cuffs were placed around subjects' thighs and inflated at a pressure 5 mm Hg below the individuals' diastolic pressures. 30 min after thigh cuff inflation, renin significantly increased in all volunteers (mean = 125%). Inflation of cuffs induced a decrease of right atrial pressure, cardiopulmonary blood volume, and cardiac output, but there were no changes in the extra-arterial systolic and diatoloic pressure or in the pressure amplitude. After cuffs were deflated, renin and hemodynamic parameters returned toward normal. In nine volunteers in whom thigh cuff inflation initially elicited renin increases, subsequent intravenous propranolol (0.25 mg/kg) abolished the response to repeated cuff inflation. The renin increase to thigh cuff inflation was absent or suppressed in four patients with a recently transplanted denervated kidney. It is concluded that thigh cuff inflation elicited a reflex-mediated renin increase, and that the reflex stemmed from stimulation of cardiopulmonary mechanoreceptors.
对24名健康志愿者和4名双侧肾切除术后接受功能性肾移植的患者,研究了血浆肾素活性(肾素)以及腿部静脉血液淤积时的血流动力学反应。在受试者大腿周围放置血压袖带,并以低于个体舒张压5mmHg的压力充气。大腿袖带充气30分钟后,所有志愿者的肾素显著升高(平均升高125%)。袖带充气导致右心房压力、心肺血容量和心输出量降低,但动脉外收缩压和舒张压或压力幅度没有变化。袖带放气后,肾素和血流动力学参数恢复正常。在9名最初因大腿袖带充气导致肾素升高的志愿者中,随后静脉注射普萘洛尔(0.25mg/kg)消除了对重复袖带充气的反应。4名近期移植了去神经支配肾脏的患者,对大腿袖带充气没有出现或抑制了肾素升高。结论是,大腿袖带充气引发了反射介导的肾素升高,且该反射源于心肺机械感受器的刺激。