Cardiovascular and vasoactive hormone responses to bladder distension in spinal and normal man
Cardiovascular and vasoactive hormone responses to bladder distension in spinal and normal man
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脊柱和正常人的心血管和血管活性激素对膀胱扩张的反应
DOI：
10.1038/sc.1992.81
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
L. Howes
中科院分区：
文献类型：
--
作者：
H. Krum;W. Louis;D. Brown;S. Clarke;J. Fleming;L. Howes
许多高位脊髓损伤的患者会因膀胱扩张而出现血压过度升高。为了研究与这些反应相关的体液机制，在基线和膀胱充盈缓慢后膀胱扩张期间测量了23名受试者的ECG心率、血压和血管活性激素水平：9名高位脊柱病变患者，7名低位脊柱病变患者和7名正常对照受试者。高位脊髓损伤组在膀胱扩张期间收缩压显著升高，平均升高56 mmHg（48%），舒张压升高22 mmHg（47%），而心率平均下降7.4次/分钟（15%）。与此相反，无论是收缩压或舒张压，也没有心率变化，在膀胱扩张的低脊柱病变或正常对照组。在高位脊髓损伤组中，膀胱扩张期间去甲肾上腺素、肾素、醛固酮、血管加压素、精氨酸或心钠素的血浆水平没有显著变化，可以解释血压升高。这些结果表明，体液机制不太可能在介导高脊柱病变患者膀胱扩张引起的升压反应中起主要作用。
Many patients with high spinal cord injury experience exaggerated blood pressure rises in response to bladder distension. To examine the humoral mechanisms associated with these responses, ECG heart rate, blood pressure and vasoactive hormone levels were measured at baseline and during bladder distension following slow bladder filling in 23 subjects: 9 high spinal lesion patients, 7 low spinal lesion patients and 7 normal control subjects. Systolic blood pressure rose significantly during bladder distension in the high spinal lesion group by an average of 56 mmHg (48%) and diastolic blood pressure rose by 22 mmHg (47%), while heart rate fell by a mean of 7.4 beats per minute (15%). By contrast, neither systolic or diastolic blood pressure nor heart rate changed significantly during bladder distension in the low spinal lesion or normal control group. There were no significant changes in plasma levels of noradrenaline, renin, aldosterone, vasopressin, arginine, or atrial natriuretic peptide during bladder distension to account for the blood pressure rise in the high spinal lesion group. These findings suggest that humoral mechanisms are unlikely to play a major role in the mediation of pressor responses to bladder distension in high spinal lesion patients.