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1、Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University1心血管活动的调节Regulation of cardiovascular activityDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University2Regulation of cardiovascular activity(心血管活动的调节)oNervous regulation(神经调节)nCardiac vagus nerve(迷走神经)n
2、Cardiac sympathetic nerve(交感神经)oHumoral regulation(体液调节)oRegulation of local blood flow(局部血流调节)Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University3Nervous regulation(神经调节)o心脏和血管的神经支配n心脏oCardiac sympathetic nerve(心交感神经)交感神经NE受体正性变时、变力、变传导作用oCardiac vagus nerve(心迷走神经)迷走神经AchM
3、受体负性变时、变力、变传导作用o神经紧张n血管o交感缩血管纤维交感缩血管纤维NE受体血管收缩o舒血管纤维Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University4Nervous regulation(神经调节)o心血管中枢心血管的基本中枢在延髓 o心血管反射 n压力感受器反射 过程:生理意义:经常监视血压的变动减压反射的重新调定Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University5Nervous
4、regulation(神经调节)n化学感受器反射 过程:O2 、CO2 、H+ 颈动脉体、主动脉体化学感受器兴奋呼吸、心血管中枢兴奋 生理意义:参与机体应急状态时循环功能的调节。心肺感受器反射 n心肺感受器反射感受器:低压力感受器:心肺感受器心肺化学感受器:前列腺素、缓激肽生理意义:在调节血流量、体液量及其成分中有重要意义。Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University6Humoral regulation(体液调节)o定义:血液和组织液中某些化学物质对心肌和血管平滑肌活动的调节oEpi
5、nephrine and norepinephrine(肾上腺素和去甲肾上腺素 )nEpinephrineo心1受体兴奋作用,产生正性变时、变力作用,使心输出量增加,临床上作为强心药使用。o血管受体(皮肤、胃肠肾)收缩o血管2受体(骨骼肌肝)舒张o小剂量 2受体,大剂量 受体Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University7Humoral regulation(体液调节)nNorepinephrineo心1受体兴奋作用 o血管受体收缩o主要与血管上受体结合,使血管强烈收缩,外周阻力增加,升
6、高血压,临床上作为缩血管升压药使用。 o肾素血管紧张素n血管紧张素作用 o小、微动脉收缩 oNE释放增加 o交感缩血管神经元紧张性增加 o释放醛固酮 o其他:血管升压素、心钠素、前列腺素等等Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK UniversityRegulation of local blood flow(局部血流调节)o代谢性性自身调节机制o肌源性自身调节机制8Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK U
7、niversity9Regional circulation器官循环Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University10决定器官血流量的因素o灌注动脉压o流出静脉压o血管阻力Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University11Coronary circulation(冠脉循环)o冠脉循环的解剖特点n主动脉根部左右冠状动脉毛细血管网静脉窦右心房n左右冠脉及其分支变异较大n冠状动脉有大量垂
8、直进入心肌的分支n毛细血管网极为丰富,1:1n动脉之间有侧支吻合o冠脉循环的血流特点n短、快n量大n受心脏搏动影响o冠脉循环与临床疾病Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University12Innervation of heartDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University13Nervous regulation舌咽神经迷走神经颈动脉窦主动脉弓压力感受器心迷走中枢心交感中枢缩血管中枢延
9、 髓脊 髓交感缩血管纤维血管血管心心心交感神经心迷走神经外周阻力心输出量动脉血压动脉血压高位中枢Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University14Location of the arterial baroreceptorsDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University15Firing rate in the afferent neurons from the carotid sin
10、us baroreceptor in relation to the magnitude of mean arterial pressureDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University16Relationship between the intrasinusal pressure & BP Demao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University17Baroreceptor reflexDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University18Renin-angiotensin systemDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University19Coronary blood flowDemao Song, M.D. & Ph.D., Dept of physiology & pathophysiology, PK University20冠状动脉与临床疾病