EFFECTS OF THE COLD PRESSOR TEST ON MUSCLE SYMPATHETIC-NERVE ACTIVITY IN HUMANS
EFFECTS OF THE COLD PRESSOR TEST ON MUSCLE SYMPATHETIC-NERVE ACTIVITY IN HUMANS
复制标题
DOI：
10.1161/01.hyp.9.5.429
复制
发表时间：
1987-05-01
期刊：
影响因子：
8.3
通讯作者：
MARK, AL
中科院分区：
文献类型：
--
作者：
VICTOR, RG;LEIMBACH, WN;MARK, AL
这项研究的目的是通过直接测量清醒人类的神经流量来确定冷加压试验对交感神经流出的影响，并测试交感神经放电与动脉压、心率和血浆去甲肾上腺素变化之间的相关性。在25名健康受试者手浸入冰水中2分钟后，经皮将微电极插入小腿腓骨肌神经束，测量动脉压、心率和肌交感神经活动。在冷加压测试的第一分钟和第二分钟，动脉压稳步上升。肌肉交感神经活动(爆发频率。次数。幅度)在测试的前30秒内没有增加，而是从230。+-增加。27至386+-52个单位(平均+-Se，p<；0.05)，在测试的第一分钟结束，并至574.+-。73(p<；0.01)在第二分钟。相比之下，心率在冷加压测试的前30秒内最大限度地增加，并在第二分钟恢复到对照水平。这种心率的增加被β-肾上腺素能受体阻滞剂消除。在冷加压试验中，肌交感神经活动的增加与平均动脉压(r=0.86，p<；0.01)和外周静脉去甲肾上腺素(r=0.72，p<；0.05)的增加有关，而神经交通的大变化与血浆去甲肾上腺素的小变化有关。本研究的主要新结论是：1)交感神经流出对骨骼肌的刺激是交感神经对冷加压试验反应的重要组成部分；2)冷加压试验似乎对交感神经流出到心脏和骨骼肌产生不同的影响；3)对冷加压试验的动脉压反应提供了一个适当的肌肉交感活性指标。
The purpose of this study was to determine the effects of the cold pressor test on sympathetic outflow with direct measurements of nerve traffic in conscious humans and to test the strength of correlation between sympathetic nerve discharge and the changes in arterial pressure, heart rate, and plasma norepinephrine. In 25 healthy subjects, arterial pressure, heart rate, and muscle sympathetic nerve activity were measured with microelectrodes inserted percutaneously into a peroneal muscle nerve fascicle in the leg during immersion of the hand in ice water for 2 minutes. Arterial pressure rose steadily during the first and second minutes of the cold pressor test. Muscle sympathetic activity (burst frequency .times. amplitude) did not increase in the first 30 seconds of the test but increased from 230 .+-. 27 to 386 .+-. 52 units (mean .+-. SE, p < 0.05) by the end of the first minute of the test and to 574 .+-. 73 (p < 0.01) during the second minute. In contrast, heart rate increased maximally during the first 30 seconds of the cold pressor test and returned to control during the second minute. This increases in heart rate were abolished by .beta.-adrenergic blockade. The increases in muscle sympathetic activity during the cold pressor test were correlated with the increases in both mean arterial pressure (r = 0.86, p < 0.01) and peripheral venous norepinephrine (r = 0.72, p < 0.05); however, large changes in nerve traffic were associated with small changes in plasma norepinephrine. The major new conclusions from this study are that 1) stimulation of sympathetic neural outflow to skeletal muscle is an important component of the sympathetic response to the cold pressor test, 2) the cold pressor test appears to produce differential effects on sympathetic outflow to the heart and to the skeletal muscles, and 3) the arterial pressure response to the cold pressor test provides an appropriate index of muscle sympathetic activity in this setting.