在VVS之前的渐进性巴罗反射功能障碍和低血压:一个恶性循环?
D L Jardine1,2,3, V Stott4, C Frampton5
1Department of General Medicine, Christchurch Hospital, Riccarton Rd, Christchurch, 8041, New Zealand. david.jardine@cdhb.health.nz.
概括
血管的前体,是由同情力回应力增加的下降引起的. 在患有血管的患者中,尽管在基线和早期倾斜过程中同情活性升高,但这种情况仍在发生.
科学领域:
- 心血管生理学
- 自主神经系统功能
- 神经科学
背景情况:
- 血压逐渐下降的特征,在血管之前出现.
- 在昏迷前,对同情神经系统活动的精确控制尚不清楚.
- 了解前的机制对于治疗血管至关重要.
研究的目的:
- 阐明前的机制,特别是同情活动的作用.
- 调查在昏睡前的同情和心血管回应变化.
- 与健康对照组相比,在血管的患者中区分自主反应.
主要方法:
- 血管和对照患者倾斜试验的回顾性分析.
- 血液动力学和肌肉交感神经活动的测量.
- 使用序列方法在不同阶段 (基线,倾斜,临,恢复) 评估血管交感和心血管气体反射增强.
主要成果:
- 与对照组相比,患有血管的患者在基线和早期倾斜时表现出更多的交感和心血管回应.
- 在昏睡前,同情力气反射显著下降,与平均动脉压失去了相关性.
- 在一些患者中,交感神经活动在恢复后下降到基线水平 (倾斜回落).
结论:
- 昏迷似乎是由同情气回应增强的下降引起的.
- 这种增益的下降发生在血管患者最初增加的同情气体反射灵敏度中.
- 这些发现突显了自主调节在昏迷过渡期间的关键转变.
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