Hudlická O
Clin Physiol. 1985 Jun;5(3):201-29.
Nervous control of muscle blood flow, exerted mainly by the sympathetic adrenergic fibres, is important under resting conditions and also mainly during haemorrhage (when both alpha and beta receptors are involved), during fight and flight and in flow redistribution to muscles during exercise. The role of other fibres (cholinergic, histaminergic and peptidergic) is discussed. Myogenic control is responsible for the high basal tone and, consequently, the relatively low resting blood flow. The main regulatory mechanism is, however, the adaptation of blood flow to metabolic demands. Thus at rest, flow is higher in muscles with a high proportion of oxidative fibres. The regulation of flow in contracting muscles is exerted by metabolites, and various metabolites seem to play different roles to different extents in different types of contractions, with several factors probably involved at any one time. Potassium seems to be more important in mixed, predominantly glycolytic, muscles during tetanic or long-lasting isometric contractions; inorganic phosphate plays a role in short-lasting contractions and is probably more involved in highly oxidative muscles. Adenosine may play a role in long-lasting contractions in muscles with a high proportion of oxidative fibres. Dilatation of arterioles enables so-called capillary recruitment during muscle contractions, which seems to be mainly the result of changes in the velocity of red blood cells and a variable percentage of capillaries with intermittent flow (with very few cells with zero velocity and a more homogeneous flow in contracting muscles) rather than opening of unperfused capillaries.
肌肉血流的神经控制主要由交感肾上腺素能纤维发挥作用,在静息状态下很重要,在出血期间(此时α和β受体均参与)、战斗或逃跑时以及运动期间肌肉血流重新分布时也主要起作用。文中还讨论了其他纤维(胆碱能、组胺能和肽能纤维)的作用。肌源性控制导致较高的基础张力,因此静息血流相对较低。然而,主要的调节机制是使血流适应代谢需求。因此,在静息时,氧化纤维比例高的肌肉血流较高。收缩肌肉中的血流调节由代谢产物发挥作用,不同的代谢产物在不同类型的收缩中似乎在不同程度上发挥不同作用,在任何一个时刻可能涉及多种因素。在强直或持久等长收缩期间,钾在混合的、主要是糖酵解型的肌肉中似乎更为重要;无机磷酸盐在短暂收缩中起作用,可能在高氧化型肌肉中作用更大。腺苷可能在氧化纤维比例高的肌肉的持久收缩中发挥作用。小动脉扩张使得在肌肉收缩期间能够实现所谓的毛细血管募集,这似乎主要是红细胞速度变化以及间歇性血流的毛细血管比例变化(收缩肌肉中极少有零速度的细胞且血流更均匀)的结果,而非未灌注毛细血管的开放。