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心力衰竭是以心脏泵血功能降低(心输出量减少)为始动因素的临床综合征。心输出量降低首先引起动脉压力感受性反射失负荷,进而通过迷走-交感机制加快心率;同时,支配血管床的交感传出活动增强,进而增加总外周阻力。本文主要论述在心力衰竭状态下压力感受性反射在循环功能异常调控中的作用机制。本综述及我们近年的研究表明:(1)在心力衰竭状态下压力感受性反射功能明显减弱;(2)中枢血管紧张素Ⅱ和活性氧在压力感受性反射功能失调中发挥关键作用;(3)心交感传入刺激和化学感受性反射能抑制压力感受性反射;(4)适当的运动可以部分纠正异常的心血管反射活动。
Heart failure is a clinical syndrome characterized by a decrease in cardiac pump function (reduced cardiac output). Decreasing cardiac output first causes a loss of arterial baroreceptor reflex, which in turn speeds up the heart rate through vagal-sympathetic mechanisms, and at the same time increases the sympathetic efferent activity of the vascular bed, thereby increasing total peripheral resistance. This article focuses on the role of baroreceptor reflex in the regulation of circulatory dysfunction in heart failure. This review and our recent studies show that: (1) baroreceptor reflex function is significantly reduced in heart failure; (2) central angiotensin II and reactive oxygen species play a key role in the baroreflex dysfunction; (3) heart Sympathetic afferent stimulus and chemosensory reflex suppress baroreflex; (4) Appropriate exercise can partially correct abnormal cardiovascular reflex activity.