颈部交感神经干及交感神经节受刺激因素的解剖学观察及其临床意义

目的:了解颈交感神经干及交感神经节的解剖特点及其与颈椎周围组织的解剖关系,为临床诊治椎(间)孔外颈神经卡压提供解剖学基础。方法:解剖20具(40侧)成人尸体标本,观察颈交感神经干及交感神经节与周围组织结构的解剖关系,测量前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带外缘与交感神经干的距离。2具新鲜尸体作Masson染色,了解前斜角肌、头长肌、颈长肌腱性组织成分。结果:颈上交感神经节周围常有肿大的淋巴结,颈下(星状)神经节下端紧贴第一肋椎关节。前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带均为腱性结合。颈交感干在C_5横突处距前斜角肌腱性交叉起点左侧为2.6±0.5cm,右侧为2.1±1.1cm,距头长肌、颈长肌腱性束带外缘左侧为2.4±0.4cm,右侧为2.5±0.8cm。结论:颈上交感神经节周围肿大的淋巴结,颈下(星状)神经节下端增生的第一肋椎关节,前斜角肌腱性交叉起点和颈长肌、头长肌腱性束带是造成颈交感神经干及交感神经节在椎(间)孔外受到刺激的解剖学因素。     

交感神经颈下节的应用定位研究

在头痛的研究当中,偏头痛的研究是最多的,认为它是以发作性搏动性头痛为特征的血管舒缩失调引起的疾病,职工学生发病率为10.3～15.9%,儿童发病率为2.0～4.6%。可应用药物治疗,但疗效均不令人满意,近来有人用交感神经颈下节阻滞方法进行治疗,取得了良好效果,但颈下神经节位置较深,周围毗邻关系复杂,经皮进行易产生许多并发症及副损伤。本文研究之目的,旨在为经皮阻滞时寻找一条最为方便安全之途径。1　材料与方法　　在30具经福尔马多处理的成人尸体上,常规方法仔细暴露出60侧交感神经颈下节,用肉眼进行其形态学观察,用游标卡尺进行了各种数…     

强度中频电刺激健康男性腰交感神经节后下肢远端皮肤血流的改变

背景：飞行人员由于长时间保持固定坐姿,腿部活动范围受限,易引起腿部血液循环不畅,产生疲劳感。研究显示中频电流具有明显的促进局部血液循环的作用。 目的：探讨低强度中频电刺激腰交感神经节对健康男性下肢远端皮肤血液循环的影响,并与静态干扰电疗法作比较。 方法：在39名健康男性腰部交感神经节(T10~L2)放置中频电电极,右内踝关节上方2 cm处放置激光多普勒血流监测仪探头,电流强度为感觉阈。分别给予调制中频电刺激、静态干扰电刺激及不通电刺激。激光多普勒血流监测仪记录静息15 min后及电刺激20 min末的血流值。 结果与结论：与基线值比较,经调制中频电刺激的受试者下肢远端皮肤血流灌注量有所增加,而未给予电刺激及静态干扰电刺激的受试者下肢远端皮肤血流灌注量有所减少,尤其是经静态干扰电刺激后,明显低于基线值(P < 0.05)。说明调制中频电刺激可以改善下肢的血液循环,对长时间保持固定坐姿产生的疲劳有缓解功能。     

交感神经颈上节的定位应用研究

1 材料与方法在30具(60侧)成人尸体上,解剖出交感神经颈上节,用游标卡尺对该节的形态、位置进行了各种观察和测量.其中3例颈上神经节做冰冻切片,并在光学显微镜下,观察了节内神经元胞体的分布情况.2 结果2.1 颈上神经节的形态、左右多不对称,但两侧最常见的形态为梭形,占60%,椭圆形次之.以下各值均以厘米计.颈上神经节的大小:左侧长度平均值为2.44,标准差0.74,标准误0.70;宽度平均值为0.80,标准差0.13,标准误0.12;厚度平均值为0.26,标准差0.05,标准误0.04.右侧长度平均值为2.64,标准差0.65,标准0.61;宽度平均值0.74,标准差0.07,标准误0.06;厚度平均值0.25,标准差0.08,标准误0.08.     

川芎嗪对牛磺酸引起的交感神经节细胞膜电位变化的影响

实验中将牛磺酸（以任氏液为溶剂配成所需浓度的溶液）按一定时间间隔滴加到含有牛蛙椎旁交感神经节的灌流槽中，以引起交感神经节较为恒定的膜电位反应。采用细胞外微电极技术，记录离体灌流的牛蛙椎旁交感神经节细胞膜电位，观察川芎嗪对牛磺酸介导反应的抑制作用。牛磺酸（10mmol/L)可引起神经节细胞膜超极化（n=38)、去极化（n-14)以及去极化之后伴随超极化过程的双相反应（n=8)、GABAA受体拮抗剂荷包牡丹碱（500μmol/L）可抑制牛磺酸（10mmol/L)的超极化反应（n=6)。无钙溶液灌流对牛磺酸（10mmol/L)介导的反应无影响。川芎嗪 （300μmol/L）可抑制牛磺酸（10mmol/L)的超极化反应（n=13)、去极化反应（n=6)和双相反应（n=4)。结果表明川芎嗪对牛蛙椎旁交感神经节牛磺酸介导的膜电位变化有抑制作用。     

高原急性缺氧对大鼠交感神经节内TH表达的影响

目的　观察急性高原缺氧大鼠交感神经节内交感神经元细胞超微结构及酪氨酸羟化酶（TH）表达的变化,为探讨TH在高原高血压病发生发展中的作用提供依据。 方法　WKY大鼠随机分为平原对照组（C）、缺氧1d组（H1）、缺氧3d组（H3）、缺氧7d组（H7）4组。应用电镜技术,观察低氧环境下交感神经节内交感神经元细胞超微结构的变化;应用qPCR和Western blot法,研究大鼠交感神经节内TH表达的变化。 结果　与同周龄的C组大鼠相比较,缺氧组大鼠血压明显升高（P<0.05）;qPCR和Western blot结果显示：与同周龄的C组大鼠相比,H1组、H3组大鼠交感神经节内TH表达降低,H7组大鼠TH表达增高（P<0.05）;电镜结果显示：高原低氧环境下交感神经细胞的形态、细胞器的数量和结构均有改变。 结论　急性高原低氧对大鼠交感神经节内交感神经元细胞形态结构存在一定影响,并影响TH表达的变化,从而影响高血压的形成。     

前庭刺激对后循环血流的影响

目的:利用TCD(经颅多普勒超声)研究前庭刺激对后循环的影响.方法:健康查体人员30例,男14例,女16例,30℃水50ml刺激前庭诱发其自主神经反应,于刺激前、后分别测定基底动脉(BA)、两侧大脑后动脉(PCA)的血流动力学指标:收缩峰速度(Vs)、舒张末速度(Vd)、平均血流速度(Vm)、搏动指数(PI).结果:所有受试者在前庭刺激初,基底动脉的Vm较刺激前明显增加(P＜0.05),PI明显降低(P＜0.05),而两侧大脑后动脉的Vm明显降低(P＜0.05),PI明显增加(P＜O.05).结论:后循环中基底动脉Vm的增加是由于前庭刺激后前庭小脑、脑干等部位活动加强的缘故,大脑后动脉Vm的降低反映了前庭刺激后视觉皮层的活动被抑制,以避免使人痛苦的振动幻视的发生,而搏力指数的改变反映了为适应不同情况下的血管舒缩功能的变化.     

川芎嗪对蟾蜍交感神经节细胞上ATP电位的影响

川芎嗪(ligustrazin)为中药川芎提取物中的一种单体有效成分,化学结构为四甲基丙嗪(tetramethylpyrazine,TMP),有研究报道,TMP能阻断兴奋在神经肌肉接头及突触中的传递,具有负性肌力作用,其抑制效应是否通过三磷酸腺苷(adenosine 5-triphosphate,ATP)尚无文献报道。本文用蟾蜍的交感神经节为实验材料,观察川芎嗪对ATP电位的影响。     

刺激中缝背核观察尼莫地平及颈交感神经对家兔脑皮质微血流的影响

目的 :探讨电刺激兔中缝背核 (DRN)对家兔脑皮质微血流的影响及其机理。方法 :应用氢清除法测定局部脑组织血流 (rCBF)及观测软脑膜血管微循环。结果 :电刺激DRN后脑皮质rCBF减少 44 .2 % (P<0 .0 1) ,软脑膜微动脉管径缩小 ,血流速度减慢 ,而尼莫地平可取消其作用。切断颈交感神经后再刺激DRN ,rCBF减少 15 .8% (P <0 .0 5 )。结论 :电刺激DRN可导致脑皮质微动脉收缩 ,局部血流减少。尼莫地平可解除脑皮质微血管痉挛。切断颈交感神经有降低rCBF的作用。     

神经肽Y在兔颈部交感神经节与脊神经节间通路应用研究

目的　通过电刺激兔颈脊神经节,检测颈交感神经节内的神经肽Y （neuropeptide Y,NPY）含量,研究颈交感神经节与颈脊神经节间的通路联系,探讨颈性眩晕发病机制中的神经解剖学基础。 方法　96只新西兰兔随机分为C2、C3、C4、C5、C6、C7组及相应对照组（每组8只）,麻醉后显露相应的脊神经节,给予波宽0.5 ms、频率30 Hz、5 V电刺激,5秒/次,每1 min重复1次,共5次,30 min后,灌注固定,切取双侧颈上、下交感神经节,切片,免疫反应,染色,观察。 结果　电刺激C2、C3脊神经节后,同侧颈上交感神经节内NPY含量升高（P<0.05）;电刺激C4、C5脊神经节后,同侧颈上交感神经节和颈下交感神经节内NPY含量均有明显变化（P<0.05）;电刺激C6、C7脊神经节后,同侧颈下交感神经节内NPY含量升高（P<0.05）。 结论　颈脊神经节和颈交感神经节间存在神经电生理上的通路联系,且具有节段性、同侧性特点,为颈性眩晕的发病机制及临床分型提供了实验依据和理论基础。     

Early effects of cervical sympathetic stimulation on cerebral,ocular and cochlear blood flow

Autoregulatory mechanisms may be expected to modify effects of vasomotor nerve stimulation in many tissues. Attempts were made to reveal a distinct early, but transient effect of cervical sympathetic stimulation on cerebral, retinal and cochlear blood flow. The labelled microsphere method was used to determine regional blood flow during electrical stimulation of the cervical sympathetic chain for 15–25 s and 5 min. At a frequency of 6 Hz there was a 5% reduction in cerebral flow at 15–25 s and 7% at 5 min. In the choroid plexus the mean reduction was 22% at 15–25 s but decreased to 10% after 5 min. In the cerebellum, optic nerve and retina, sympathetic stimulation had no appreciable effect on the blood flow. In the cochlea and iris, the blood flow reductions were 25 and 32%, respectively, on both occasions. In the choroid, vasoconstriction increased with time, whereas in the masseter muscle there was a decrease. Thus in the present experiments no indication was found of an autoregulatory escape phenomenon in the brain, the eye or the cochlea. Some escape was noted in the masseter muscle.     

Sympathetic effects on cerebral and ocular blood flow in rabbits pretreated with indomethacin

The effects of unilateral stimulation of the cervical sympathetic chain on cerebral and ocular blood flow was investigated in 8 rabbits anesthetized with pentobarbital sodium and pretreated with indomethacin in order to inhibit the formation of prostaglandins. Blood flow determinations were made with the labelled microsphere method during normotension and acute arterial hypertension. Hypertension was induced by ligation of the thoracic aorta. Evans blue was given as a tracer for protein leakage during hypertension. Sympathetic stimulation had no significant effect on the blood flow in the brain under the two conditions studied. In the uvea marked effects of sympathetic stimulation were obtained at normotension as well as at hypertension. There were no indications of breakdown of the blood-brain barrier or the blood-aqueous barrier. Thus, there was no evidence for any prostaglandin-mediated inhibition of sympathetic effects in the brain or the eye.     

高压氧干预交感神经型颈椎病患者椎基底动脉血流的变化

背景：交感型颈椎病病因、发病机制尚不明确,目前无明确的客观检查标准,经颅多普勒超声仪能够直接对椎-基底动脉系统进行血流动力学监测,可作为交感神经型颈椎病诊断的一项客观指标。高压氧治疗对交感型颈椎病患者椎基底动脉血流速度影响的报道较少。 目的：观察高压氧治疗对交感神经型颈椎病患者椎基底动脉血流速度及疗效的影响。 方法：将交感神经型颈椎病患者随机分为2组,观察组采用德国吕内堡医疗公司的电脑控制脉冲牵引和多人空气加压高压氧舱治疗;对照组仅采用德国吕内堡医疗公司的电脑控制脉冲牵引治疗。治疗前后均采用经颅多普勒超声仪检查右椎动脉、左椎动脉、基底动脉多普勒血流速度的变化情况。 结果与结论：观察组血流减慢41例患者在治疗后双侧椎动脉、基底动脉血流速明显增快(P < 0.01);血流增快22例患者治疗后双侧椎动脉、基底动脉血流速明显减低(P < 0.01)。对照组患者除左椎动脉收缩期血流速度及基底动脉舒张期血流速度有改变外,余无明显改变。观察组患者治愈率及总有效率显著高于对照组(P < 0.01)。提示高压氧对交感神经型颈椎病患者椎基底动脉血流速度有明显改善作用,具有双相调节性,血流速度监测可作为交感神经型颈椎病诊断和疗效判定的一项客观依据。同时高压氧是治疗交感神经型颈椎病较有效的方法。     

Decoding rule from vasoconstrictor skin sympathetic nerve activity to nonglabrous skin blood flow in humans at normothermic rest

Although an importance of vasoconstrictor skin sympathetic nerve activity (SNA) in control of cutaneous circulation is widely recognized, the decoding rule that translate dynamic fluctuations of vasoconstrictor skin SNA into skin blood flow is not fully understood. In 10 male subjects who rested in supine position under normothermic condition, we measured skin blood flow index (by laser-Doppler flowmetry) at the dorsum pedis, and vasoconstrictor skin SNA (by microneurography) that was confirmed to innervate the same region as the flow index. We determined the transfer and coherence functions from the neural activity input to the flow and quantified the contribution and predictability from the input to output by system engineering technique. The results showed that in frequency-domain analysis, the transfer function from vasoconstrictor skin SNA to skin blood flow had low-pass filter characteristics with 3.6 ± 0.1 s of pure time delay. The coherence function was approximately 0.5 between 0.01 and 0.1 Hz and less above 0.1 Hz. In time-domain analysis, the predictability from the SNA to the skin blood flow was approximately 50%. These findings indicate that at normothermic rest, the decoding rule from vasoconstrictor skin SNA to skin blood flow of skin is characterized by low-pass filter with 3–4 s of pure time delay, and that the vasoconstrictor skin SNA contributes to a half of fluctuation of skin blood flow in the condition. The incomplete dependence of skin blood flow on vasoconstrictor skin SNA may confirm nonneural mechanisms to control cutaneous circulation even at normothermic rest.     

Effects of sympathetic stimulation on cerebral and ocular blood flow Modification by hypertension,hypercapnia, acetazolamide,PGI2 and papaverine

The effect of unilateral, electrical stimulatio of the cervical sympathetic chain in rabbits anesthetized with pentobarbital sodium and vasodilated by hypercapnia, acetazolamide, papaverine or PGI₂ was investigated to determine to what extent the sympathetic nerves to the brain and the eye cause vasoconstriction and prevent overperfusion in previously vasodilated animals. Evans blue was given as a tracer for protein leakage. Blood flow determinations were made with the labelled microsphere method during normotension and acute arterial hypertension. Hypertension was induced by ligation of the thoracic aorta and in some animals metaraminol or angiotensin was also used. Acetazolamide caused a two to threefold increase in cerebral blood flow (CBF) and hypercapnia resulted in a fivefold increase. CBF was not markedly affected by papaverine or PGI₂. In the choroid plexus, the ciliary body and choroid, papaverine and hypercapnia caused significant blood flow increases on the control side. Sympathetic stimulation induced a 12 % blood flow reduction in the brain in normotensive, hypercapnic animals. Marked effects of sympathetic stimulation at normotension were obtained under all conditions in the eye. In the hypertensive state the CBF reduction during sympathetic stimulation was moderate, but highly significant in hypercapnic or papaverine-treated animals as well as in controls. Leakage of Evans blue was more frequently seen on the nonstimulated side of the brain. In the eye there was leakage only on the control side except in PGI₂-treated animals where 2 rabbits had bilateral leakage. The effect of sympathetic stimulation on the blood flow in the cerebrum and cerebellum in vasodilated animals seems to be small or absent if the blood pressure is normal. In the eye pronounced vasoconstriction occurs under these conditions. In acute arterial hypertension sympathetic stimulation protects both the cerebral and ocular barriers even under conditions of marked vasodilation.     

Effect of pyrrolidone-pyroglutamic acid composition on blood flow in rat middle cerebral artery

We compared the effects of a pyrrolidone-pyroglutamic acid composition and nimodipine on blood circulation in the middle cerebral artery in rats. The composition produced a strong effect on blood supply to the brain, stimulated blood flow in the middle cerebral artery (by 60±9%) and decreased blood pressure (by 25.0±2.7%). The cerebrovascular effects of this composition differed from those of nimodipine. Nimodipine not only increased middle cerebral artery blood flow, but also decreased cerebral blood flow in the early period after treatment. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 141, No. 1, pp. 56–58, January, 2006     

上颈性眩晕发生的颈交感神经及第2颈神经的解剖学因素观察

目的 明确颈上神经节（superior cervical ganglion,SCG）与第2颈神经及椎动脉的解剖关系,为临床诊治上颈性眩晕提供形态学基础。 方法 解剖15具（30侧）成人尸体标本,观察颈上神经节与C2的交通支及至椎动脉的分支。 结果 5侧未见SCG与C2之间存在神经连接;25侧存在神经连接,其中18侧存在迷走神经参与,7侧可见SCG分支支配椎动脉。SCG分支与C2前支汇合后,交感神经纤维分别至C2前、后支及椎动脉。 结论 SCG与C2的交通支及其对椎动脉的支配关系,可为阐明上颈性眩晕发病机理及建立有效治疗方案提供重要解剖学依据。     

复杂动脉血管内血液流动的研究进展

动脉硬化是一种严重影响人类健康的动脉血管常见病。大量的研究证明动脉硬化病灶的产生与动脉管壁的切应力分布有着密切的联系，其易友部位位于腹主动脉末端、冠状动脉、颈动脉分又等处。本文就动脉硬化的易发部位出发，对复杂动脉血管内血液流动的近期研究作一综述。     

Identification of sites of sympathetic outflow at rest and during emotional arousal: Concurrent recordings of sympathetic nerve activity and fMRI of the brain

The sympathetic nervous system subserves many of the autonomic responses to mental stress and emotional processing. While peripheral markers of sympathetic activity can be obtained indirectly – by measuring heart rate, blood pressure, sweat release and skin blood flow – these effector-organ responses are slower compared to the directly recorded sympathetic nerve activity. Microneurography, in which a tungsten microelectrode is inserted percutaneously into a peripheral nerve in awake human subjects, allows one to record sympathetic nerve activity to either muscle or skin. Muscle sympathetic nerve activity (MSNA) is involved in the beat-to-beat control of blood pressure, and is elevated during mental stress; chronic stress can lead to high blood pressure. The primary role of skin sympathetic nerve activity (SSNA) is to regulate body temperature by controlling sweat release and skin blood flow, but it has also been commandeered for emotional expression. In this review we discuss our recent work in which we have performed concurrent microelectrode recordings of MSNA or SSNA and fMRI of the brain, with a view to identifying areas in the brain responsible for generating the increases in sympathetic outflow at rest and during emotional engagement. Spontaneous bursts of MSNA at rest were positively correlated to activity in the left dorsomedial hypothalamus and left insula, and bilaterally in the ventromedial hypothalamus, dorsolateral prefrontal cortex, posterior cingulate cortex and precuneus. Spontaneous bursts of SSNA at rest were positively correlated with activity in the left ventromedial nucleus of the thalamus, the left posterior and right anterior insula, the right orbitofrontal and frontal cortices and bilaterally in the mid-cingulate cortex and precuneus. Increases in SSNA occurred when subjects viewed emotionally charged images, resulting in increases in activity in the central and lateral amygdala, dorsolateral pons, thalamus, nucleus accumbens, and cerebellar cortex; surprisingly, there was no activation of the insula in response to these emotional stimuli. We have shown that concurrent microelectrode recordings of sympathetic outflow to either muscle or skin and fMRI of the brain can be used to identify areas of the brain involved in the generation of sympathetic nerve activity. We propose that this approach can be extended to examine specific disorders of emotional expression to increase our understanding of the underlying neural processes.