颈动脉体的生理和病理功能(英文)

Carotid body function in health and disease

外周颈动脉体化学感受器在介导低动脉血氧、高碳酸血症和酸中毒等信号过程中发挥着重要作用。它将信号传到中枢引起化学感受性反射,是低氧通气反应以及低氧血症引起循环系统一系列反应的关键。众所周知,外周和中枢化学感受器的交互作用在机体通气反应调节中至关重要,而且,颈动脉体的化学感受器活动在运动时的通气反应和体液调节中及高原地区慢性低氧所致的通气习服反应中起重要作用。在疾病状态下,如高血压、睡眠呼吸障碍(包括阻塞性睡眠呼吸暂停)和充血性心力衰竭的患者以及动物疾病模型中,化学感受器的活动及其反射的敏感性都显著提高。颈动脉体在生理状况下维持着机体的血氧稳定,在病理状况下参与了疾病的发展。因此,颈动脉体的细胞和分子调节机制可用来解释许多疾病的病理生理过程。

Peripheral chemoreceptors in the carotid body play a significant role in the transduction of chemical stimuli in the arterial blood notably hypoxia,hypercapnia and acidosis to the central for eliciting the chemoreflex,which is central to the hypoxic ventilatory response and is also important for the circulatory responses to hypoxia.It is known that interactions between the peripheral and central chemoreceptors are crucial to the magnitude of the reflex response for the ventilatory control.In addition,the carotid chemoreceptor activity contributes to the ventilatory and humoral responses to exercise and also significantly to the ventilatory acclimatization to chronic hypoxia at high altitude.Under diseased conditions,there are augmented chemoreceptor activity and chemoreflex sensitivity in patients with hypertension or sleep-disordered breathing including obstructive sleep apnea（OSA） and congestive heart failure and also in experimental animal models mimicking these diseases.Thus,the carotid body functions to maintain the oxygen homeostasis;whereas anomalous carotid chemoreceptor activities associated with diseases could be both adaptive and pathogenic in nature,for which cellular and molecular mechanisms have been proposed for the pathophysiogical consequences.