臨牀透析 Vol.13 No.10(2)


特集名 透析患者の血圧管理の実際
題名 生理的血圧維持機構
発刊年月 1997年 09月
著者 阿部 倫明 東北大学医学部第二内科
著者 伊藤 貞嘉 東北大学医学部第二内科
【 要旨 】 健常人の平均血圧は約100mmHgに保たれている.この血圧を維持するために,種々の機構が常に巧みに作動している.自律神経系は急性の血圧調節機構であり,血圧の安定性に重要である.その障害は血圧の動揺性を大きくするが,慢性的な高血圧の成因とならないと考えられる.レニン-アンギオテンシン系に代表される体液性因子は中期的血圧調節機構であり,腎臓による長期的血圧調節と密接な関係がある.腎臓による長期的血圧調節は体液の恒常性を保つという腎臓に課せられた一義的な役割と深く関連しており,圧-利尿曲線が重要である.したがって,高血圧など慢性の血圧調節の異常には腎臓の関与が必須であると考えられる.
Theme Blood Pressure Control in Chronic Renal Failure
Title The physiological mechanism that controls blood pressure
Author Michiaki Abe Second Department of Internal Medicine, Tohoku University
Author Sadayoshi Ito Second Department of Internal Medicine, Tohoku University
[ Summary ] The mean arterial pressure of the healthy adult human is maintained at approximately 100mmHg. To maintain this pressure, various systems operate constantly in a well-integrated manner. The autonomic nervous system has a rapidly acting mechanism, which is important for blood pressure stability. Although its impairment leads to very unstable pressure, it is not thought to cause chronic hypertension. The hormonal factor represented by the renin-angiotensin system is an intermediate time-period pressure control mechanism, which is closely related to the long-term control of arterial pressure by the kidney.The long-term mechanism for arterial pressure regulation is closely associated with a basic role of the kidney, namely maintenance of body fluid and electrolyte homeostasis, which the pressure-natriuresis curve plays an important role. Therefore, involvement of the kidney would be necessary for long-term disturbance of blood pressure regulation, such as that seen in hypertension.
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