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交感神经系统与肾脏之间的相互作用:实验观察

Interactions between the sympathetic nervous system and the kidney: experimental observations.

作者信息

Stella A, Zanchetti A

出版信息

J Hypertens Suppl. 1985 Dec;3(4):S19-25.

PMID:3913755
Abstract

Increasing evidence suggests that the renal nerves may contribute to the pathogenesis of several types of experimental hypertension. It has been demonstrated that renal denervation can either attenuate the severity or delay the development of hypertension in spontaneously hypertensive rats (SHR), in DOCA-salt treated rats and in renovascular hypertensive rats. On the other hand, intrarenal administration of catecholamines has been shown to elicit an increase in systemic arterial pressure as long as the infusion is continued. The underlying mechanisms by which renal nerves might participate in the regulation of cardiovascular homeostasis have not been entirely clarified. It is known that efferent renal nerve activity, by exerting a direct influence on renal arteriolar tone, renin release and sodium and water excretion, can interfere with the control of arterial pressure by modifying peripheral resistances, circulating angiotensin II and volume balance. In addition, a role of afferent renal nerve activity in cardiovascular control and, possibly, in the pathogenesis of renovascular hypertension, has recently been proposed after the demonstration of mechano- and chemoreceptors inside the kidney. Indeed, blood pressure is reflexly influenced either by several manoeuvres applied to the kidney or by the electrical stimulation of afferent renal nerve fibres. Afferent and efferent renal nerve activity appear to be closely related since recent experiments by our group have provided further evidence of the existence of neural renorenal reflexes by which one kidney exerts a tonic inhibitory effect on the release of renin from juxtaglomerular cells and on tubular sodium and water reabsorption of the contralateral kidney.

摘要

越来越多的证据表明,肾神经可能参与了几种类型实验性高血压的发病机制。已经证实,肾去神经支配可以减轻自发性高血压大鼠(SHR)、去氧皮质酮盐处理大鼠和肾血管性高血压大鼠的高血压严重程度或延缓其发展。另一方面,只要持续输注,肾内给予儿茶酚胺已被证明会引起全身动脉压升高。肾神经参与心血管稳态调节的潜在机制尚未完全阐明。已知传出肾神经活动通过对肾小动脉张力、肾素释放以及钠和水排泄施加直接影响,可通过改变外周阻力、循环中的血管紧张素II和容量平衡来干扰动脉压的控制。此外,在肾脏内部发现机械感受器和化学感受器后,最近有人提出传入肾神经活动在心血管控制以及可能在肾血管性高血压发病机制中的作用。确实,通过对肾脏施加的几种操作或通过传入肾神经纤维的电刺激,血压会受到反射性影响。传入和传出肾神经活动似乎密切相关,因为我们小组最近的实验进一步证明了神经肾-肾反射的存在,即一侧肾脏对另一侧肾脏肾小球旁细胞肾素释放以及肾小管钠和水重吸收具有紧张性抑制作用。

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