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心力衰竭状态下的动脉压力感受器反射

王玮, 朱国庆, 高列, 谭文, 钱忠明

美国内布拉斯加州立大学医学中心生理和生物物理系. 美国, 奥马哈；南京医科大学生理教研室. 江苏, 南京 210029；苏州创新药物动物实验研究中心. 江苏, 苏州 215011；香港理工大学应用生物和化学技术系

摘要

心力衰竭是以心脏泵血功能降低(心输出量减少)为始动因素的临床综合征.心输出量降低首先引起动脉压力感受性反射失负荷,进而通过迷走-交感机制加快心率;同时,支配血管床的交感传出活动增强,进而增加总外周阻力.该文主要论述在心力衰竭状态下压力感受性反射在循环功能异常调控中的作用机制.本综述及我们近年的研究表明:(1)在心力衰竭状态下压力感受性反射功能明显减弱;(2)中枢血管紧张素Ⅱ和活性氧在压力感受性反射功能失调中发挥关键作用;(3)心交感传入刺激和化学感受性反射能抑制压力感受性反射;(4)适当的运动可以部分纠正异常的心血管反射活动。

关键词： 压力感受器反射; 化学感受器反射; 心力衰竭; 血管紧张素Ⅱ; 活性氧; 运动训练

Baroreceptor reflex in heart failure

Wang Wei, Zhu Guoqing, Gao Lie, Tan Wen, Qian Zhongming

Department of Physiology and Biophysics, University of Nebraska College of Medicine Omaha. NE 68198-4575, USA；Department of Physiology, Nanjing Medical University. Nanjing 210029, China；Suzhou Preclinical Animal Testing Center. Suzhou 215011, China；Applied Biology & Chemical Technology, The Hong Kong Polyechnic University. Hung Hom, Kowloon. Hong Kong

Abstract

Congestive heart failure is a syndrome that is usually initiated by a reduction in pump function of the heart, i.e. a decrease in cardiac output. Initially, a reduction in cardiac output leads to unloading of baroreceptor reflex that, in turn, increases heart rate through vago-sympathetic mechanisms and total peripheral resistance via an increase in sympathetic outflow to vascular beds. In this review we are thinking on how baroreceptor reflex plays a role in the abnormal control of the circulation in heart failure. This review and our recent studies suggest that: (1) baroreceptor reflex is blunted in heart failure; (2) central angiotensin Ⅱ and reactive oxygen species play an important role in blunted baroreceptor reflex; (3) cardiac sympathetic afferent stimulation and chemoreceptor reflex inhibit baroreceptor reflex; and (4) exercise training normalizes abnormal reflexes in the heart failure state.

Key words: baroreceptor reflex; chemoreceptor reflex; heart failure; angiotensin Ⅱ; reactive oxygen species; exercise training

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引用本文：

王玮, 朱国庆, 高列, 谭文, 钱忠明. 心力衰竭状态下的动脉压力感受器反射[J]. 生理学报 2004; 56 (3): .

Wang Wei, Zhu Guoqing, Gao Lie, Tan Wen, Qian Zhongming. Baroreceptor reflex in heart failure. Acta Physiol Sin 2004; 56 (3): (in Chinese with English abstract).