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[电解质在高血压发生和维持中的作用]

[Role of electrolytes in the development and maintenance of hypertension].

作者信息

Fujita T, Ando K

机构信息

Fourth Department of Internal Medicine, University of Tokyo School of Medicine, Japan.

出版信息

Nihon Naibunpi Gakkai Zasshi. 1994 May 20;70(4):423-30. doi: 10.1507/endocrine1927.70.4_423.

Abstract

Sodium (Na) intake is one of the important environmental factors influencing the development and maintenance of high blood pressure (BP). Patients with essential hypertension can be divided into two groups: "salt-sensitive" and "non-salt-sensitive", according to BP response to salt loading, suggesting the heterogeneity of salt sensitivity of BP. Salt-sensitive patients had greater increases in BP by salt loading, associated with greater Na retention. Although the precise mechanism for impaired renal Na handling in salt-sensitive patients is still unknown, the sympathetic nervous system in the kidney may play an important role in the decreased renal function of Na excretion and the increased salt sensitivity. Moreover, there are several pieces of evidence indicating that increased renal sympathetic nerve activity is intimately related to the abnormal central noradrenergic systems. In addition, the renin-angiotensin system, insulin, and so on, may modulate salt sensitivity of BP. Some ions influence the hypertensinogenic effect of Na: Chloride ion facilitates it, while potassium, calcium and magnesium antagonize it. Moreover, obesity and a stressful environment increase salt sensitivity of BP.

摘要

钠(Na)摄入是影响高血压(BP)发生和维持的重要环境因素之一。原发性高血压患者可根据血压对盐负荷的反应分为两组:“盐敏感型”和“非盐敏感型”,这表明血压盐敏感性存在异质性。盐敏感型患者经盐负荷后血压升高幅度更大,且与更多的钠潴留有关。虽然盐敏感型患者肾脏钠处理受损的确切机制尚不清楚,但肾脏交感神经系统可能在肾钠排泄功能降低和盐敏感性增加中起重要作用。此外,有几条证据表明,肾交感神经活动增加与中枢去甲肾上腺素能系统异常密切相关。此外,肾素-血管紧张素系统、胰岛素等可能调节血压的盐敏感性。一些离子影响钠的升压作用:氯离子促进其作用,而钾、钙和镁则拮抗其作用。此外,肥胖和压力环境会增加血压的盐敏感性。

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