頸動脈鼻按摩的病理生理方面
J Gert van Dijk1, Boriana S Gagaouzova1,2, Jelle S Y de Jong3,4
1Department of Neurology, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands.
概括
心脏抑制 (CI) 和动脉血管抑郁 (aVD) 是对动脉鼻按摩的不同的反应. CI是一种早期的,短暂的反应,而aVD是一种延迟的反应,两者都会导致血压下降.
科学领域:
- 心血管生理学心血管生理学
- 自主神经系统调节自主神经系统调节
背景情况:
- 冠状动脉鼻腔按摩 (CSM) 用于评估自主功能.
- 了解CSM期间血压 (BP) 降低的独特机制对于诊断昏迷至关重要.
研究的目的:
- 为了研究心脏抑制 (CI) 和动脉血管抑制 (aVD) 后的特征CSM.
- 为了确定CI和aVD是否独立发生.
- 阐明在CSM期间影响BP降低终止的因素.
主要方法:
- 从两个荷兰昏迷中心对244名CSM进行了血压,心率 (HR),中风体积和外周总阻力 (TPR) 的回顾性分析.
- 根据HR和TPR从基线偏差来定义CI和aVD.
- 使用逻辑法来分析相对变化,并评估CI和aVD的同时发生和依赖.
主要成果:
- 在CSM中,CI发生在48%,aVD发生在30%的CSM中.
- CI和aVD的同时发生的频率不高于偶然.
- 与aVD相比,CI是一个更早,更快,更短的反应,具有类似的整体血压降低效果.
- 更长的按摩持续时间增强了AVD,整体血压下降.
- 血压下降引发了HR和TPR的纠正性增加.
结论:
- CI是对CSM发病的相性反应,独立于aVD.
- aVD是一种更隐藏的反应,对持续的按摩敏感.
- 高血压的纠正机制可能涉及到逆侧心动脉鼻和大动脉巴罗受体.
- 纠正反应的有效性可能会影响CSM后的整体血压下降.
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