Cardiovascular responses to bladder distension in patients with spinal transection.
Cardiovascular responses to bladder distension in patients with spinal transection.
复制标题
脊柱横断患者的心血管对膀胱扩张的反应。
DOI：
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发表时间：
1975
影响因子：
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通讯作者：
W. C. Randall
中科院分区：
文献类型：
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作者：
R. Wurster;W. C. Randall
在控制膀胱压升高期间，记录7例脊髓横断在椎体水平T5以上的患者和另4例T5以下的患者的动脉血压、心率和皮肤体积脉冲。当病变位于T5以上时，膀胱扩张可引起收缩压和脉压的显著升高。T5以下病变的升高较少。受“孤立”脊髓支配的皮肤区域血管明显收缩，而受近端脊髓支配的区域血管被动扩张。7例T5以上病变患者中，只有3例在动脉血压显著升高时出现心率下降。T5以上病变患者脉压的明显升高不能仅仅通过血管收缩增加和心率降低来解释，还涉及心脏的肌力反应。这些肌力反应是由心脏交感神经介导的，这些交感神经离开T5水平以上的脊髓。
Arterial blood pressure, heart rate, and cutaneous volume pulses were recorded during controlled elevation of urinary bladder pressure in a group of seven patients with spinal cord transsection above vertebral level T5 and in another group of four patients below T5. Profound elevations in systolic blood pressure and pulse pressure were induced by bladder distension when the lesion was situated above T5. Lesser elevations occurred in patients with lesions below T5. Marked vasoconstriction characterized skin areas innervated by the "isolated" spinal cord, while passive dilatation occurred in areas supplied by the proximal cord. Only three of seven patients with lesions above T5 level had decreased heart rate during marked elevations in arterial blood pressure. The marked elevations in pulse pressure in patients with lesions above T5 could not be explained solelyby increased vasoconstriction and decreased heart rate, but involves also inotropic cardiac responses. These inotropic responses are mediated by cardiac sympathetic nerves which leave the spinal cord above the T5 level.