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肾去神经支配可预防具有遗传性压力感受器反射受损的盐敏感兔的钠潴留和高血压。

Renal denervation prevents sodium retention and hypertension in salt-sensitive rabbits with genetic baroreflex impairment.

作者信息

Weinstock M, Gorodetsky E, Kalman R

机构信息

Department of Pharmacology, Hebrew University Hadassah Medical Centre, Jerusalem, Israel.

出版信息

Clin Sci (Lond). 1996 Apr;90(4):287-93. doi: 10.1042/cs0900287.

Abstract
  1. Rabbits with a genetic impairment in baroreflex control of heart rate become hypertensive on a high salt diet. The present study determined the effect of bilateral renal denervation on blood pressure and sodium balance after salt loading (four times normal intake; 28-36 mEq NaCl/day) in normotensive rabbits with high (Group I) and low (Group II) baroreflex sensitivity, respectively. 2. Eight rabbits in each group were denervated or sham-denervated 1 week before commencement of the high salt diet. Before operation, the two groups differed only in the gain of their cardiac baroreflex (Group I, -6.4 +/- 0.4 beats min-1 mmHg-1; Group II, -3.2 +/- 0.15 beats min-1 mmHg-1). 3. In Group I sham-denervated rabbits, mean arterial pressure remained unchanged, and plasma renin activity and heart rate fell significantly in response to the high salt. In Group II sham-denervated rabbits, mean arterial pressure increased by 10.6 +/- 1.2 mmHg, and heart rate and plasma renin activity remained unchanged. Their cumulative Na+ retention and weight gain was more than twice that of Group I sham-denervated rabbits. 4. Renal denervation decreased plasma renin activity in both groups to < 1 pmol Ang I h-1 ml-1, lowered cumulative Na+ retention from 102 +/- 4 to 35 +/- 5 mEq (P < 0.01) and completely prevented the increase in mean arterial pressure in response to high salt in Group II. 5. The results suggest that Group II rabbits retain salt and fluid in response to their diet because of an abnormality in their control of renal nerve activity, possibly via vagal afferents. This results in blood pressure elevation because of an inability to lower peripheral resistance and heart rate in response to the increase in cardiac output. 6. Since they display several of the characteristics of salt-sensitive hypertensive humans, i.e. salt retention, normal plasma renin activity, but abnormal regulation of plasma renin activity and blood flow in response to salt loading, Group II are an appropriate model of human salt-induced hypertension.
摘要
  1. 心率压力反射控制存在基因缺陷的兔子在高盐饮食时会出现高血压。本研究分别测定了双侧肾去神经支配对血压正常、压力反射敏感性高(I组)和低(II组)的兔子在高盐负荷(正常摄入量的四倍;28 - 36 mEq氯化钠/天)后血压和钠平衡的影响。2. 每组八只兔子在高盐饮食开始前1周进行去神经支配或假手术。术前,两组仅在心脏压力反射增益方面存在差异(I组,-6.4±0.4次/分钟·毫米汞柱-1;II组,-3.2±0.15次/分钟·毫米汞柱-1)。3. 在I组假手术兔子中,平均动脉压保持不变,血浆肾素活性和心率因高盐饮食而显著下降。在II组假手术兔子中,平均动脉压升高了10.6±1.2毫米汞柱,心率和血浆肾素活性保持不变。它们的累积钠潴留和体重增加是I组假手术兔子的两倍多。4. 肾去神经支配使两组的血浆肾素活性均降至<1 pmol血管紧张素I/小时·毫升-1,将累积钠潴留从102±4降至35±5 mEq(P<0.01),并完全阻止了II组因高盐饮食导致的平均动脉压升高。5. 结果表明,II组兔子因其肾神经活动控制异常,可能通过迷走传入神经,对饮食产生盐和液体潴留反应。这导致血压升高,因为无法因心输出量增加而降低外周阻力和心率。6. 由于II组兔子表现出盐敏感性高血压人类的几个特征,即盐潴留、正常血浆肾素活性,但对盐负荷时血浆肾素活性和血流的调节异常,所以II组是人类盐诱导性高血压的合适模型。

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