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心肺和颈动脉压力反射对内脏和前臂循环的控制。

Cardiopulmonary and carotid baroreflex control of splanchnic and forearm circulations.

作者信息

Escourrou P, Raffestin B, Papelier Y, Pussard E, Rowell L B

机构信息

Service d'Explorations Fonctionnelles, Institut National de la Santé et de la Recherche Médicale CJF 8909, Hôpital Antoine Béclère, Clamart, France.

出版信息

Am J Physiol. 1993 Mar;264(3 Pt 2):H777-82. doi: 10.1152/ajpheart.1993.264.3.H777.

Abstract

The objective was to determine whether a rise in carotid sinus transmural pressure by neck suction (NS) would counteract vasoconstriction secondary to inhibition of discharge of arterial and cardiopulmonary baroreceptors by simultaneous lower body negative pressure (LBNP). NS alone was applied to seven normal human subjects at -40 mmHg for 400-600 ms at each heartbeat during a 6-min period. NS reduced mean arterial pressure (MAP) from 94 +/- 6 to 86 +/- 9 mmHg and heart rate (HR) from 64 +/- 5 to 60 +/- 4.7 beats/min but did not affect vascular resistance in the splanchnic region (flow by constant infusion of indocyanine green; assumed constant extraction) or in the forearm (venous occlusion plethysmography). The same NS stimulus was applied during 23 min of continuous LBNP at -40 mmHg. LBNP alone before NS significantly reduced central venous pressure (CVP) from 5 +/- 0.3 to 1 +/- 0.5 mmHg and raised splanchnic (+34%) and forearm (+70%) vascular resistances and HR (from 64 to 74 beats/min) without reducing MAP. NS plus LBNP reduced MAP from 103 +/- 8 to 95 +/- 6 mmHg and HR from 74 +/- 6 to 67 +/- 5 beats/min without changing CVP but did not alter vascular resistances, which remained elevated and constant throughout LBNP before and after NS. Increments in plasma concentrations of renin (240%), aldosterone (70%), epinephrine (112%), and norepinephrine (46%) accompanied LBNP and NS; a separate influence of NS was not discernible. We conclude that vasoconstriction in response to combined cardiopulmonary and aortic inhibition is not overpowered by carotid sinus stimulation.

摘要

目的是确定通过颈部抽吸(NS)使颈动脉窦跨壁压升高是否会抵消因同时施加下体负压(LBNP)抑制动脉和心肺压力感受器放电而继发的血管收缩。在6分钟期间,对7名正常人类受试者在每次心跳时以-40 mmHg的压力单独施加NS 400 - 600毫秒。NS使平均动脉压(MAP)从94±6 mmHg降至86±9 mmHg,心率(HR)从64±5次/分钟降至60±4.7次/分钟,但不影响内脏区域(通过持续输注吲哚菁绿测量流量;假定提取率恒定)或前臂(静脉闭塞体积描记法)的血管阻力。在-40 mmHg的持续LBNP 23分钟期间施加相同的NS刺激。在NS之前单独的LBNP显著降低中心静脉压(CVP)从5±0.3 mmHg降至1±0.5 mmHg,并使内脏(+34%)和前臂(+70%)血管阻力以及HR升高(从64次/分钟升至74次/分钟),而不降低MAP。NS加LBNP使MAP从103±8 mmHg降至95±6 mmHg,HR从74±6次/分钟降至67±5次/分钟,而不改变CVP,但不改变血管阻力,在NS前后整个LBNP期间血管阻力保持升高且恒定。肾素(240%)、醛固酮(70%)、肾上腺素(112%)和去甲肾上腺素(46%)的血浆浓度升高伴随LBNP和NS;未发现NS的单独影响。我们得出结论,对心肺和主动脉联合抑制的血管收缩反应不会被颈动脉窦刺激所克服。

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