SYMPATHETIC OVERACTIVITY IN PATIENTS WITH CHRONIC-RENAL-FAILURE
SYMPATHETIC OVERACTIVITY IN PATIENTS WITH CHRONIC-RENAL-FAILURE
复制标题
DOI：
10.1056/nejm199212313272704
复制
发表时间：
1992-12-31
影响因子：
158.5
通讯作者：
VICTOR, RG
中科院分区：
文献类型：
--
作者：
CONVERSE, RL;JACOBSEN, TN;VICTOR, RG
背景高血压是慢性肾功能衰竭的常见并发症，但其原因尚不完全清楚。有间接的证据表明，交感神经系统的活动增加可能有助于终末期肾病患者的高血压，但交感神经放电尚未在慢性肾功能衰竭的患者或动物中直接测量。应用腓神经微电极记录18例自体肾长期血液透析患者（其中14例合并高血压）、5例双侧肾切除血液透析患者（其中1例合并高血压）和11例正常人的交感神经节后放电到骨骼肌血管的频率。接受血液透析但未行肾切除术的患者交感神经放电的平均（+/-SE）频率是正常人的2.5倍（58+/-3 vs. 23+/-3脉冲/分钟，P <0.05）。
Background. Hypertension is a frequent complication of chronic renal failure, but its causes are not fully understood. There is indirect evidence that increased activity of the sympathetic nervous system might contribute to hypertension in patients with end-stage renal disease, but sympathetic-nerve discharge has not been measured directly in patients or animals with chronic renal failure.Methods. We recorded the rate of postganglionic sympathetic nerve discharge to the blood vessels in skeletal muscle by means of microelectrodes inserted into the peroneal nerve in 18 patients with native kidneys who were undergoing long-term treatment with hemodialysis (ot whom 14 had hypertension), 5 patients receiving hemodialysis who had undergone bilateral nephrectomy (of whom 1 had hypertension), and 11 normal subjects.Results. The mean (+/-SE) rate of sympathetic-nerve discharge was 2.5 times higher in the patients receiving hemodialysis who had not undergone nephrectomy than in the normal subjects (58+/-3 vs. 23+/-3 bursts per minute, P