整理:李治中
在一場演講上聽到,腎臟沒有副交感神經。當下覺得真是個令人震驚的(冷)知識,也反省自己怎麼以前唸書時沒有留意。事後從google著手,再轉到手邊可得的電子教科書,卻發現——說法似乎並不一致。
Wikipedia說「the kidney also receives input from the parasympathetic nervous system, by way of the renal branches of the vagus nerve; the function of this is yet unclear.」腎臟有副交感神經但功能並不清楚。
教科書一Berne and Levy Physiology 7e說「There is no corresponding parasympathetic innervation.」斬釘截鐵,腎臟沒有副交感神經。
教科書二Guyton and Hall Textbook of Medical Physiology 14e表示「The vagus nerves supply parasympathetic nerves to the heart, lungs, esophagus, stomach, entire small intestine, proximal half of the colon, liver, gallbladder, pancreas, kidneys, and upper portions of the ureters.」從迷走神經來的副交感神經有到腎臟。
教科書三Ganong's Review of Medical Physiology 26e走中間路線,這麼描述「There also appears to be a cholinergic innervation via the vagus nerve, but its function is uncertain.」Appear這個字在此用得真巧妙。似乎有似乎無。
至於腎臟科聖經The kidney,如果我沒有漏讀,選擇不提有或沒有副交感神經,只細述了交感神經的部分。
如果有一天學弟妹或患者突然一問:「請問一下,腎臟有副交感神經嗎?」雙手一攤,還真是不知道該怎麼回答才好。要是當下心情不好,可能甚至不小心這樣脫口而出:「你管腎臟有沒有副交感神經做什麼,先管好你自己再說吧!」