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  4. T. 109, № 12, 2023

Российский физиологический журнал им. И.М. Сеченова, 2023, T. 109, № 12, стр. 1725-1741

Нейрогенная регуляция мозгового кровотока

Д. Д. Ваулина 1, *, Д. Ю. Бутко 2, А. А. Карпов 1, М. М. Галагудза 1, 3

1 Национальный медицинский исследовательский центр имени В.А. Алмазова Министерства здравоохранения Российской Федерации
Санкт-Петербург, Россия

2 Санкт-Петербургский государственный педиатрический медицинский университет Министерства здравоохранения Российской Федерации
Санкт-Петербург, Россия

3 Институт аналитического приборостроения Российской академии наук
Санкт-Петербург, Россия

* E-mail: uplavice@gmail.com

Поступила в редакцию 27.06.2023
После доработки 06.10.2023
Принята к публикации 06.10.2023

Аннотация

Головной мозг имеет хорошо развитую сосудистую сеть, что позволяет ему потреблять до 15% сердечного выброса при незначительной массе относительно массы всего тела. В норме метаболические потребности головного мозга значительно зависят от интенсивности функционирования различных его отделов, что требует постоянной регуляции уровня местного кровотока. С другой стороны, состояние системной гемодинамики может оказывать значительное влияние на органный кровоток. Сложные и многоуровневые механизмы регуляции органного мозгового кровотока направлены на минимизацию возможных неблагоприятных последствий влияния нарушений системной гемодинамики. К основным механизмам регуляции мозгового кровотока относят: миогенную регуляцию, влияние местных гуморальных воздействий и вазоактивных веществ (гормонов, метаболитов) системного кровотока, изменение газового состава крови (повышение или снижение в крови напряжения кислорода или углекислого газа). Кроме того, выделяют эндотелий-зависимые механизмы регуляции. Наконец, еще один уровень регуляции тонуса мозговых артерий представлен воздействием нейротрансмиттеров, высвобождающихся из терминалей вазомоторных волокон симпатического и парасимпатического отделов вегетативной нервной системы, а также из окончаний субкортикальных нейронов и кортикальных интернейронов. В настоящем обзоре рассмотрены принципы нейрогенной регуляции мозгового кровотока. Нейрогенная регуляция сосудистого тонуса представляет собой наиболее сложный контур регуляции. Вегетативная иннервация мозговых сосудов имеет существенные особенности, отличающие ее от таковой в большинстве других органов большого круга кровообращения. Кроме собственно вегетативной иннервации, сосуды головного мозга получают сенсорную иннервацию, а мелкие внутримозговые артериолы также иннервируются непосредственно нейронами подкорковых ядер и кортикальными интернейронами. В этой связи более глубокое понимание молекулярных механизмов нейрогенной регуляции мозгового кровотока в перспективе может послужить основой для разработки новых методов лечения тяжелых заболеваний головного мозга, основанных на нейромодуляции.

Ключевые слова: головной мозг, нейрогенная регуляция, симпатическая иннервация, парасимпатическая иннервация, сенсорная иннервация

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