交感神经阻断药.pptVIP

5.交感神经兴奋对免疫功能的影响急性应激导致冠心病患者炎症因子增强,血小板激活而出现心梗过度的应激则降低免疫功能一定的应激增强免疫功能三、交感神经过度兴奋与心血管疾病的关系Grassietal.2008盐的摄入和交感神经的张力老年高血压患者均明显增加交感神经持续兴奋的原因010203遗传学基础(基因多态性)心理因素(A型性格)肥胖β肾上腺素受体的基因多态性与药物个体差异精氨酸/甘胺酸=３/１交感神经兴奋的心理因素:A型性格敌意,考虑事情坏的一面Hostility时间急迫感,急燥Timeurgency/Impatient上进(争强好胜)Achivementstriving/petitveness除了遗传因素外,还涉及成长环境、认知水平及文化等多方面因素胰岛素促进交感神经兴奋胰岛素、瘦素等中枢性调节作用将代谢性疾病(肥胖、糖尿病)与高血压联系在一起肥胖高血压患者选用β肾上腺素受体阻断剂？JCI1992;90:24–29β受体阻断剂适用人群0150岁以下心率过快高血压患者02合并心衰等严重并发症高血压患者GRK：G蛋白偶联受体蛋白激酶，使受体磷酸化而失活（Gprotein-coupledreceptors(GPCRs)；GPCRkinases(GRKs)）Arrestins：从胞浆中转运到细胞（内）膜，与受体结合而使其与G蛋白脱偶联****Hormonesensitivelipase,HSL.MostimportantstimulatorysignalsiscatecholaminesactingBadrenergicreceptors,otherhormonesincludingglucagon,parathyroidhormone和心钠素等(Natriureticpeptides)游离脂肪酸增加．其实在血中绝大多数是和白蛋白结合的,”非脂化脂肪酸”这个术语更准确些.1.GS促进正常人食欲．消耗脂肪后，还必须补充足够的脂肪，因此ＧＳ促进食欲是合理的.Effectsofglucocorticoidsonenergymetabolismandfoodintakeinhumans.Endocrinologymetabolism,1996:317-252.美食减压Chronicstressandobesity:Anewviewof“comfortfood”ProcNatlAcadSciUSA.2003September30;100(20):11696–11701.****Stimulationofβ3-adrenergicreceptorsleadstothedramaticincreaseintheintracellularconcentrationoftriiodothyronine(T3)bymeansofthetype25deiodinase(D2);Mitochondriareleasechemicalenergyintheformofheatbymeansoftheuncouplingoftheoxidativephosphorylation,makingtheprocessofrespirationexceedinglyinefficient.Uncoupleproteins1:UCP1,whichcausestheleakageofprotonsfromtheinnermembraneofthemitochondria,hencedissipatingenergyintheformofheatratherthanstoringitasATP..CREcAMPresponseelement,TREthyroidhormoneresponseelement****Enhancingversussuppressiveeffectsofstresshormonesonskinimmunefunction.ProcNatlAcadSciUSA.1999;96(3):1059–1064PathophysiologicalprocessesunderlyingemotionaltriggeringofacutecardiaceventsProcNatlA