The kidney as a sensor: functional evidence.
The kidney as a sensor: functional evidence.
复制标题
肾脏作为传感器：功能证据。
DOI：
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发表时间：
1992
期刊：
影响因子：
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通讯作者：
A. Stella
中科院分区：
文献类型：
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作者：
A. Stella
目的
目的：探讨肾传入神经活动对心血管反射控制和容量平衡的影响。
解剖学和电生理学证据
在肾脏中，已发现对机械和化学刺激敏感的受体。来自肾脏的传入纤维已被证明沿肾神经和背根移动，主要从T9到L4，并在脊髓和棘上水平投射到中枢神经系统。大多数参与心血管控制的脑干区域和下丘脑前部的几个区域(包括加压素分泌神经元)接受来自肾传入神经的输入。
反射对心血管系统的影响
电刺激肾传入神经纤维可使体动脉压升高或降低。电刺激肾传入引起的高血压反应是交感神经系统广泛激活，导致外周血管阻力增加的结果。通过肾动脉内注入腺苷激活传入肾神经纤维可引起动脉压、心率和心输出量持续增加，而不改变总外周阻力，这表明交感神经系统的反射激活，主要局限于心脏。在电刺激肾传入神经时观察到血浆加压素浓度的升高，这可能有助于介导肾传入神经刺激引起的高血压反应。
肾小球反射
神经肾反射的存在是公认的，通过这种反射，一个肾脏可以影响另一个肾脏的功能。对侧肾反射在本质上是抑制性的，在张力上是活跃的，主要控制肾小球旁细胞的肾素分泌和肾小管对钠和水的重吸收。
结论
证据表明，来自肾脏的感觉信息有助于心血管动态平衡和容量平衡的整体调节。
PURPOSE
To evaluate the effects of afferent renal nerve activity on reflex control of the cardiovascular system and volume balance.
ANATOMICAL AND ELECTROPHYSIOLOGICAL EVIDENCE
In the kidney, receptors sensitive to mechanical and chemical stimuli have been identified. Afferent fibres from the kidney have been shown to travel along renal nerves and dorsal roots, mainly from T9 to L4, and to project to the central nervous system at spinal and supraspinal levels. Most of the brainstem regions involved in cardiovascular control and several regions of the anterior hypothalamus (including vasopressin-secreting neurons) receive inputs from renal afferents.
REFLEX EFFECTS ON THE CARDIOVASCULAR SYSTEM
The electrical stimulation of afferent renal nerve fibres can either increase or decrease systemic arterial pressure. The hypertensive response to electrical stimulation of renal afferents is the result of widespread activation of the sympathetic nervous system, leading to an increase in peripheral vascular resistance. Activation of afferent renal nerve fibres by an intrarenal artery infusion of adenosine elicits sustained increases in arterial pressure, heart rate and cardiac output without changing total peripheral resistance, indicating reflex activation of the sympathetic nervous system, predominantly restricted to the heart. An increase in the plasma vasopressin concentration, observed during the electrical stimulation of renal afferents, might help to mediate the hypertensive response to afferent renal nerve stimulation.
RENORENAL REFLEXES
The existence of neural renorenal reflexes, by which one kidney can influence the functioning of the opposite kidney, is well established. Contralateral renorenal reflexes, which are inhibitory in nature, are tonically active and mainly control the secretion of renin from juxtaglomerular cells and the tubular reabsorption of sodium and water.
CONCLUSIONS
The evidence suggests that sensory information from the kidney contributes to the overall regulation of cardiovascular homeostasis and volume balance.