细胞外液体体积与慢性病患者交感神经系统活动之间的关联
Jinhee Jeong1,2, Kanokwan Bunsawat3,4,5,6, Jeann L Sabino-Carvalho1,2
1Division of Renal Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
American journal of physiology. Renal physiology
|December 23, 2025
概括
在慢性病 (CKD) 中,细胞外液体体积 (ECFV) 和交感神经系统 (SNS) 活动都会升高. 与预期相反,在CKD患者中,较高的ECFV与增加的SNS活动相关,而不是抑制.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心血管医学 心血管医学
- 生理学 生理学 生理学
背景情况:
- 慢性病 (CKD) 与高血和交感神经系统 (SNS) 过度活跃有关,增加心血管风险.
- 通常情况下,细胞外流体体积 (ECFV) 的增加会抑制SNS活动;然而,在CKD中,两者都会升高.
- 这项研究调查了ECFV,SNS活动和CKD患者的功能之间的关系.
研究的目的:
- 检查确定慢性结核病中ECFV增加的临床因素.
- 评估ECFV和CKD中SNS活动之间的关联.
- 为了确定功能是否影响ECFV和SNS活动之间的关系.
主要方法:
- 在104名II-IV期慢性瘤患者的横截面研究中.
- 使用多频生物阻抗 (细胞外水/全体水比) 评估ECFV.
- 肌肉交感神经活动 (MSNA) 测量在一个子集 (N=39).
- 用于评估ECFV预测因子的多变量回归分析,包括估计的膜过率 (eGFR) 和MSNA.
主要成果:
- ECFV与eGFR相反相关,与年龄,静脉血压和脉冲压相反相关.
- 在患有较高ECFV三位数的患者中,MSNA显著更高,即使经过对共变量进行调整.
- 虽然eGFR预测了ECFV,但MSNA在多变量模型中没有显示与ECFV的独立关联.
结论:
- 在II-IV阶段的CKD中,ECFV和SNS活动之间的预期反向关系不存在.
- 在CKD患者中,较高的ECFV与MSNA增加有关.
- 降低功能的同情刺激作用可能会超过慢性病中增加ECFV的同情抑制作用.
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