昼夜节律紊乱与高血压的研究进展  

Progress in Research on Circadian Disruption and Hypertension

作　　者：谌虎 周丽平[1,2] 王宇虹 余锂镭 江洪[1,2] CHEN Hu;ZHOU Liping;WANG Yuhong;YU Lilei;JIANG Hong(Department of Cardiology,Renmin Hospital of Wuhan University,Wuhan 430060,China;Cardiac Autonomic Nervous System Research Center of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院心内科,武汉430060 [2]武汉大学心脏自主神经研究中心,武汉430060

出　　处：《医学综述》2021年第8期1567-1573,共7页Medical Recapitulate

基　　金：国家自然科学基金(81871486)。

摘　　要：昼夜节律系统分为外源性和内源性节律系统,内源性节律系统的主时钟通过神经或神经内分泌途径调控血压的正常昼夜节律变化。近年来,轮班工作、夜间上班等导致的昼夜节律紊乱可导致自主神经、肾素-血管紧张素-醛固酮系统紊乱以及松果体分泌褪黑素减少,从而导致高血压的发生发展。目前高血压的治疗主要采用以药物治疗为主,改善生活习惯为辅的方式。近年出现的一些新的高血压治疗策略,如自主神经调控(迷走神经刺激、肾脏去神经治疗等)、褪黑素辅助治疗以及降压药物的时间疗法可能是昼夜节律紊乱型高血压的潜在治疗策略。The circadian rhythm system is composed of exogenous and endogenous rhythm systems.The master clock of the endogenous rhythm system regulates the circadian changes of blood pressure through neural or neuroendocrine pathway.In recent years,circadian disruption caused by shift work and night work may lead to the dysfunction of autonomic nerve system,renin angiotensin-aldosterone system and reduced pineal gland secretion of melatonin,thus leading to the occurrence and development of hypertension.At present,hypertension is mainly treated with drugs,supplemented by the improvement of living habits.In recent years,a number of new treatment strategies for hypertension have emerged,such as autonomic nerve modulation(vagal nerve stimulation,renal denervation,etc.),melatonin-assisted therapy,and chronotherapy,which may be potential treatment strategies for hypertension induced by circadian disruption.

关 键 词：高血压 昼夜节律紊乱 自主神经调控 褪黑素 时间疗法 

分 类 号：R544[医药卫生—心血管疾病]