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直立倾斜试验中心率功率谱密度及体液因素的变化 |
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陈椿 张馥敏 黄元铸 马文珠
【摘要】 目的 研究直立倾斜试验(HUT)中的心率变异及体液因素的变化。方法 60例不明原因晕厥病人及20例健康人在HUT中作心率功率谱密度(HRPSD)分析，并测定血浆去甲肾上腺素(NE)、肾素活性(RA)、血管紧张素Ⅱ(AngⅡ)及醛固酮(ALD)水平。结果 倾斜前、后5分钟HRPSD的总、超低频、低频、高频段功率谱密度、低/高频比和NE、RA、AngⅡ、ALD水平及其变化在阳性病人、阴性病人和正常对照三组均相似。试验结束前5分钟，阳性组的总、超低频、低频段功率谱密度、低/高频比显著高于阴性组和对照组（P<0.01）。试验结束时，阳性组的RA、AngⅡ及ALD显著高于阴性组和对照组（P<0.05），但三组间的NE差异无显著性。结论 HUT阳性的血管迷走性晕厥病人神经调节功能异常是晕厥的始发因素，体液调节是一种继发性代偿反应。
【关键词】 晕厥 倾斜试验
The changes of heartrate power spectral density and humoral factors during head-up tilt test CHEN Chun, ZHANG Fumin, HUANG Yuanzhu, et al. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029
【Abstract】 Objective To study the changes of neural and humoral regulation during head-up tilt test (HUT). Methods The heart rate power spectral density (HRPSD) was analysed and the plasma levels of norepinephrine (NE), renin activity (RA), angiotension-II (AngⅡ)and aldosterone (ALD) were measured in 60 patients with unexplained syncope and in 20 healthy subjects. Results The data and their changes of HRPSD in total, very low-frequency, low-frequency, high-frequency and the ratio of low-high frequency and plasma NE, RA, AngⅡ, ALD were similar among positive patients, negative patients and controls in 5 minutes before and after tilting. Five minutes before the end of test, the HRPSD in total, very low-frequency, low-frequency and the ratio of low-high frequency were significantly higher in the positive group than in the negative and control ones (P <0.01). At the end of HUT, plasma RA, AngⅡ and ALD were significantly higher in positive group than in negative and control ones (P<0.05), but there were no significant differences in NE in all three groups. Conclusion The results suggest that the abnormal regulatory function of autonomic nervous system might be the trigger factor for syncope induced by HUT, the humoral regulation might be a secondary compensating response[1] [2] [3] 下一页
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