Wehle B, Bevegård S, Castenfors J, Davidsson S, Lindblad L E
Clin Nephrol. 1983 May;19(5):236-42.
In 9 regular hemodialysis patients, the carotid baroreceptor reflex was studied using standardized carotid sinus stimulation by neck suction. All patients were studied during predialysis conditions (recirculation), and during dialysis using dialyzate sodium concentrations of 145 and 133 mmoles/l. Baroreceptor stimulation was performed during the recirculation period and after 120-266 minutes of combined dialysis and ultrafiltration. Dialysis alone with either sodium concentration tended to decrease blood pressure. Heart rate as well as plasma renin activity increased significantly during dialysis with either procedure. In contrast to the findings in healthy subjects, heart rate was not influenced by neck suction, possibly reflecting a vagal neuropathy in uremic patients. However, carotid sinus stimulation decreased systolic pressure during recirculation to the same extent as has been found in healthy subjects. Furthermore, the blood pressure response to neck suction was enhanced during dialysis. These findings suggest that the blood pressure decrease during dialysis can not be explained by defective blood pressure control by the carotid sinus baroreceptors.
在9例常规血液透析患者中，采用经颈部抽吸进行标准化颈动脉窦刺激的方法，研究了颈动脉压力感受器反射。所有患者均在透析前状态（再循环）下以及使用145和133毫摩尔/升透析液钠浓度进行透析期间接受研究。在再循环期以及联合透析和超滤120 - 266分钟后进行压力感受器刺激。单独使用任何一种钠浓度进行透析均倾向于降低血压。在两种透析过程中，心率以及血浆肾素活性均显著增加。与健康受试者的结果相反，心率不受颈部抽吸的影响，这可能反映了尿毒症患者的迷走神经病变。然而，颈动脉窦刺激在再循环期间使收缩压降低的程度与在健康受试者中发现的程度相同。此外，在透析期间，对颈部抽吸的血压反应增强。这些发现表明，透析期间的血压下降不能用颈动脉窦压力感受器对血压控制缺陷来解释。
