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½ÉÇ÷°ü »ý¸®(Cardiovascular physiology)

ÀÛ¼ºÀÚ ´ÚÅÍÄÚ¸®¾Æ Á¶È¸¼ö 7308
½ÉÇ÷°ü »ý¸®(Cardiovascular physiology)



1) Ç÷¿ªÇÐÀû ¿ä¼Ò(Hemodynamic factors)



¡¡½É¹ÚÃâ·®Àº ½É¹Ú¼ö¿Í ÀÏȸ ¹ÚÃâ·®¿¡ ÀÇÇØ °áÁ¤µÈ´Ù. ÀÏȸ ¹ÚÃâ·®Àº ÀüºÎÇÏ, ÈĺÎÇÏ, ½É±Ù ¼öÃà·Â µîÀÇ ¿ä¼Ò¿¡ ÀÇÇØ °áÁ¤µÇ¸ç, ÀÌ°ÍÀ» °ø½ÄÀ¸·Î ³ªÅ¸³»¸é ´ÙÀ½°ú °°´Ù.



¡¡¡¡¡¡½É¹ÚÃâ·® = ½É¹Ú¼ö X ÀÏȸ ¹ÚÃâ·®¡¡.......................................[1]

¡¡¡¡¡¡(cardiac output = heart rate X stroke volume)



¡¡Ç÷¾ÐÀº ½É¹ÚÃâ·®°ú Àü½Å Ç÷°ü ÀúÇ׿¡ ÀÇÇØ °áÁ¤µÈ´Ù. Ç÷°üÀۿ뼺 ¾à¹°Àº ½É¹Ú¼ö, ½É±ÙÀÇ ¼öÃà·Â, ¹æ½Ç Àüµµ¼º ¶Ç´Â Àü½Å Ç÷°ü ÀúÇ×À» º¯È­½ÃÅ°¹Ç·Î½á ¾à¸®ÇÐÀû È¿°ú¸¦ ³ªÅ¸³»¸ç, ÀÌ¿¡ °ü·ÃµÈ °ø½ÄÀº ´ÙÀ½°ú °°´Ù.





¡¡¡¡¡¡Ç÷¾Ð = ½É¹ÚÃâ·® X Àü½Å Ç÷°ü ÀúÇס¡.......................................[2]

¡¡¡¡¡¡(blood pressure = cardiac output X systemic vascular resistance)



¡¡ÀÌ·¯ÇÑ Ç÷°üÀۿ뼺 ¾à¹°ÀÇ Á÷Á¢ÀûÀÎ ÀÛ¿ëÀº ½É¹Ú¼ö, ½É±Ù ¼öÃà·Â, ¹æ½Ç Àüµµ¼º ¶Ç´Â Àü½Å Ç÷°ü ÀúÇ×À» º¯È­½ÃÅ°¹Ç·Î½á ½É¹ÚÃâ·®, ÀÏȸ ¹ÚÃâ·®, Ç÷¾Ð µîÀÇ º¯È­¸¦ ÀÌÂ÷ÀûÀ¸·Î ÃÊ·¡ÇÒ ¼ö ÀÖ´Ù.



2) ÀÚÀ² ½Å°æ°è(Autonomic nervous system)



¡¡ÀÚÀ² ½Å°æ°è´Â ±³°¨ ½Å°æ°è¿Í ºÎ±³°¨ ½Å°æ°è·Î ±¸¼ºµÇ¾î ÀÖ´Ù. ±³°¨ ½Å°æ°è´Â ÁÖ·Î Èä¿äÃß(thoracolumbar)ºÎÀ§¸¦ ÁÖÇàÇϸç Á¢ÇÕ ºÎÀ§¿¡¼­ ½Å°æ Àü´Þ ¹°Áú·Î ³ë¸£¿¡Çdz×ÇÁ¸°(norepinephrine)ÀÌ ÀÛ¿ëÇÏ°í, ºÎ±³°¨ ½Å°æ°è´Â ÁÖ·Î °æÃߺÎ(cervical)¿Í õ°ñ(sacral) ºÎÀ§¸¦ ÁÖÇàÇÏ¸ç ½Å°æÀý°ú Á¢ÇÕ ºÎÀ§¿¡¼­ ½Å°æ Àü´Þ ¹°Áú·Î ¾Æ¼¼Æ¿Äݸ°(acetylcholine)ÀÌ ÀÛ¿ëÇÑ´Ù.



¡¡½Å°æ Àü´Þ ¹°Áú°ú Ç÷°üÀۿ뼺 ¾à¹°µéÀº ¿øÇÏ´Â »ý¸®ÇÐÀû ¹ÝÀÀÀ» ¾ò±â À§ÇØ ¼­·Î ´Ù¸¥ ¼ö¿ëü¿Í »óÈ£ÀÛ¿ëÀ» ÇÑ´Ù. ÀÌ¿Í°°Àº ÀÛ¿ëÀº ÀÌ¹Ì ÀÎÁ¤µÈ ÀÌ·ÐÀ¸·Î, ÀÌ·¯ÇÑ ¼ö¿ëüµéÀÇ Á¸Àç´Â ºñ±³Àû ÃÖ±Ù¿¡ ¹ß°ßµÈ °ÍµéÀÌ´Ù. ÃÖ±Ù¿¡¾ß ¼ö¿ëüµéÀº È£¸£¸óÀ̳ª ¾à¹°°ú °áÇÕÇÏ´Â ´Ü¹éÁúÀ̶ó´Â °ÍÀÌ Áõ¸íµÇ¾ú´Ù. ¶ÇÇÑ ¼ö¿ëüÀÇ Á¾·ùµéÀº ¼öÃà·Â°ú ¼±ÅÃÀûÀÎ ±æÇ×Á¦¿ÍÀÇ °áÇÕ, ÀÌÂ÷Àü·É°æ·Î(second messenger pathway), °¢°¢ ´Ù¸¥ À¯ÀüÀÚ ±¸Á¶ µî¿¡ µû¶ó °áÁ¤µÈ´Ù.




3) ¼ö¿ëü »ý¸®ÇÐ



¡¡¼ö¿ëüµéÀº Ư¡ÀûÀ¸·Î ¼¼Æ÷¸·°ú ¼¼Æ÷Áú µÎ °÷¿¡ À§Ä¡ÇÑ´Ù. ´ë´Ù¼öÀÇ ¾àµé°ú ³»Àμº È£¸£¸óµéÀº Ä£¼ö¼ºÀ̸ç Áö¹æ¼º ¼¼Æ÷¸·Àº Àß Åë°úÇÏÁö ¸øÇÑ´Ù. ±×·¯¹Ç·Î ÀÓ»óÀÇ¿¡°Ô Áß¿äÇÑ ´ëºÎºÐÀÇ ¼ö¿ëü ±â°üµéÀº ¼¼Æ÷¸·¿¡ ºÎÂøµÈ È°¼ºÈ­µÇ±â ½¬¿î ´Ü¹éÁúµéÀÌ´Ù. º¸ÅëÀÇ ¸· ¼ö¿ëü ½ÅÈ£µµÀÔ(transmembrane receptor-signal transdution)Àº È°¼ºÈ­µÈ ¼ö¿ëü¿Í ¸Å°³¹°ÀÎ guanine nucleotide protein(G protein)°úÀÇ »óÈ£ÀÛ¿ëÀ¸·Î ³ªÅ¸³­´Ù. ¿¡³ÊÁö¸¦ Á¦°øÇϱâ À§ÇØ guanine triphosphate(GTP)°¡ guanine diphosphate(GDP)·Î °¡¼öºÐÇØµÈ ÈÄ, ÀÌ »óÈ£ÀÛ¿ëÀº ÀÌÂ÷ Àü·É(second messenger)À» È°¼ºÈ­ ½ÃŲ´Ù(±×¸² 2). ±× ÈÄ ¼¼Æ÷³»ÀÇ È­ÇÐÀûÀÎ ¿¬¼Ó ¹ÝÀÀÀÌ °á±¹ ¿øÇÏ´Â ÀÓ»óÀû °á°ú¸¦ À¯µµÇÑ´Ù. º£Å¸ ¾Æµå·¹³¯¸°¼º ¼ö¿ëüÀÇ °æ¿ì, ÃËÁøÁ¦°¡ ÀÚ±ØÇÑ G- proteinÀÌ adenyl cyclase¸¦ È°¼ºÈ­½ÃÄÑ °á°úÀûÀ¸·Î ¼¼Æ÷³» cyclic adenosine monophosphate(c-AMP)°¡ Áõ°¡ÇÑ´Ù3). °íÀüÀûÀÎ ¾Æµå·¹³¯¸°¼º ¼ö¿ëü(¾ËÆÄ 1, ¾ËÆÄ 2, º£Å¸ 1, º£Å¸ 2)´Â ½ÉÇ÷°ü°èÀÇ Ç×»ó¼º À¯Áö¸¦ À§ÇØ ¼ö¿ëü¿Í °áÇÕÇÏ´Â °¡Àå Áß¿äÇÑ G-proteinÀÌ´Ù. µµÆĹΠ¼ö¿ëü¸¦ Æ÷ÇÔÇÑ ¾Æµå·¹³¯¸°¼º ¼ö¿ëüÀÇ Æ¯¼ºµéÀº Ç¥¿Í ´ÙÀ½ ¹®Àå¿¡ Àß ³ªÅ¸³ª ÀÖ´Ù.







¸·¼ö¿ëü ½ÅÈ£µµÀÔ.



Hydrophilic endogenous hormone (H)À̳ª exogenous drug(D)ÀÌ ¸·¼ö¿ëü[transmembrane receptor(R)]ÀÇ ¼¼Æ÷¿Ü ¸é°ú °áÇÕÇÏ°í ÀÖ´Ù. ±× ´ÙÀ½ activated receptor´Â cytoplasmic intermediary guanine nucleotide protein(G)°ú »óÈ£ÀÛ¿ëÀ» ÇÑ´Ù. Guanine triphosphate(GTP)°¡ guanine diphosphate(GDP)·ÎÀÇ hydrolysis´Â effector molecule(E)°ú »óÈ£ÀÛ¿ëÇÏ´Â G protein¿¡ ÇÊ¿äÇÑ ¿¡³ÊÁö¸¦ ¿ä±¸ÇÑ´Ù. Effector moleculeÀÇ È°¼ºÀ̳ª ¾ïÁ¦´Â ¼¼Æ÷³»·ÎÀÇ È­ÇйÝÀÀÀ» ÀÏÀ¸Å²´Ù2).





Ä«Å×Äݾƹο¡ ÀÇÇÑ ¼ö¿ëü ÀÚ±ØÀÇ È¿°ú



Adrenergic receptor

Site

Action



Alpha-1



Postsynaptic receptors that regulate smooth muscle arterioles(systemic and pulmonary circulation) Vasoconstriction(increased impedance)

Iris Dilatation

Heart Increased contractility



Alpha-2



Presynaptic receptors that inhibit the release of norepinephrine of smooth muscle when stimulated Vasodilation



Beta-1



Heart Increased atrial and ventricular contraction

Sinoatrial node Increased heart rate

Atrioventricular conduction Increased conduction velocity or rate of conduction

Kidney Renin release



Beta-2



Smooth muscle arterioles(systemic and pulmonary) Vasodilatation(decreased impedance)

Bronchi Bronchodilatation

Heart Increased rate and contractility



Dopamine-1



Vascular smooth muscle

Renal and mesentery Vasodilation



Dopamine-2



Presynaptic adrenergic nerve endings Inhibits norepinephrine release





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