慢性静止不耐症:一种心脏和血管交感控制不协调的疾病
1Syncope Service in the Autonomic Dysfunction Unit, Division of Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, USA.
Circulation
|November 17, 1998
概括
慢性静态不耐受性 (COI) 涉及年轻成年人的休息交感活动的增加和对站立的交感反应的减少. 然而,巴罗反射功能仍然完好无损,这表明同情色调分布异常.
科学领域:
- 心血管生理学心血管生理学
- 自主神经系统研究 自主神经系统研究
- 临床医学 临床医学
背景情况:
- 慢性静态不耐受性 (COI) 影响年轻人,表现为残疾自主障碍.
- 在COI中神经幽默和血液动力学模式表明了对同情功能和心率的巴罗反射控制的潜在失调.
研究的目的:
- 为了研究慢性静止不耐受症患者的交感神经系统活动和巴罗反射控制.
- 为了比较COI患者和健康对照者之间在姿势挑战期间的血液动力学和神经幽默学概况.
主要方法:
- 在休息和倾斜期间同时记录动脉内血压,心电图,中央静脉压和肌肉交感神经活动.
- 对心率和血压变量的光谱分析,以评估交感血管调节和交感血管运动控制.
- 使用药理学机动和跨光谱分析评估巴罗反射灵敏度.
主要成果:
- 与对照组相比,COI患者的静止心率,肌肉交感神经活动和交感血管失衡 (LF/HF) 较高.
- 在倾斜期间,COI患者表现出心率和LF/HF的明显增加,但肌肉交感神经活动的增幅较低.
- 静止时的巴罗反射灵敏度在静止时的组之间保持了可比性,并且在倾斜时同样减少.
结论:
- COI的特点是休息时 noradrenergic调高,站立时交感反应减弱,由心交感过度活动补偿.
- 在COI患者中,巴罗反射机制功能性保持.
- 对心脏和血管系统的中心交感外流的异常功能分布与COI病理生理学有关.
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