Merlo M, Nazzaro P, Manzari M, Pirrelli A
Servizio Ipertensione Arteriosa, Università di Bari.
Boll Soc Ital Biol Sper. 1991 Dec;67(12):1007-14.
In order to evaluate a peculiar hemodynamic and psychophysiological reactivity in hypertensive-diabetics, a male population of mild essential hypertensives and mild NID hypertensive-diabetics underwent a session of tests:Arithmetic, Sacks', Cold Pressor, Hand-grip, preceded and followed by a 10' recovery period, Valsalva Manoeuver, Beat to beat, Tilt table. Along the entire session, by means of a beat to beat, non invasive computerized system, we measured some pressure, hemodynamic, and extra-cardiovascular variables. The obtained findings seem to suggest a sympathetic hyperreactivity both in HD and in H. In HD it has a particular "tropism" for peripheral vascular bed, as showed by vascular resistances and peripheral temperature responsivity; on the other hand the cardiac contractility index is more depressed than in H, suggesting that in HD, cardiac and pressor responses might be influenced by some mechanisms whose nature seem related to neither functional damage nor hemodynamic adjustments. The different profiles of the two populations seem to confirm the utility of this kind of hemodynamic, non invasive evaluation in all the pathologies where Autonomic Nervous System is involved, in order to obtain a better diagnosis approach and therapeutic treatment.
为了评估高血压糖尿病患者特有的血流动力学和心理生理反应性，对一组轻度原发性高血压男性和轻度非胰岛素依赖型高血压糖尿病男性进行了一系列测试：算术测试、萨克斯测试、冷加压测试、握力测试，测试前后各有10分钟的恢复期，还有瓦尔萨尔瓦动作、逐搏测量、倾斜试验。在整个测试过程中，通过一个逐搏测量的无创计算机系统，我们测量了一些压力、血流动力学和心血管外变量。所得结果似乎表明，高血压糖尿病患者（HD）和高血压患者（H）均存在交感神经过度反应。在高血压糖尿病患者中，如血管阻力和外周温度反应性所示，其对外周血管床具有特殊的“趋向性”；另一方面，心脏收缩指数比高血压患者更受抑制，这表明在高血压糖尿病患者中，心脏和升压反应可能受某些机制的影响，这些机制的性质似乎既与功能损害无关，也与血流动力学调节无关。这两个人群的不同特征似乎证实了这种血流动力学无创评估在所有涉及自主神经系统的疾病中的实用性，以便获得更好的诊断方法和治疗方案。
