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β肾上腺素能受体和甲状腺激素对甲状腺功能亢进症患者外周动脉血流速度和加速度的影响。

Effect of beta adrenoceptors and thyroid hormones on velocity and acceleration of peripheral arterial flow in hyperthyroidism.

作者信息

Chemla D, Levenson J, Valensi P, LeCarpentier Y, Pourny J C, Pithois-Merli I, Simon A

机构信息

Centre de Diagnostic-U28 INSERM-Hôpital Broussais, Paris, France.

出版信息

Am J Cardiol. 1990 Feb 15;65(7):494-500. doi: 10.1016/0002-9149(90)90817-k.

Abstract

Brachial artery flow patterns were studied in 10 hyperthyroid and 10 normal subjects. Mean blood velocity and flow were evaluated by pulsed Doppler, and peak systolic acceleration was calculated by computer-assisted digitization of the instantaneous velocity curve. Compared to control subjects, hyperthyroid patients had higher velocity and flow (p less than 0.01, p less than 0.02) and higher peak systolic acceleration (p less than 0.01). In hyperthyroid patients, measurements were repeated after (1) mechanical exclusion of the hand from brachial circulation, (2) short-term beta-blocker treatment and (3) inducement of the euthyroid state. Exclusion of the hand reduced velocity and flow (p less than 0.001) but did not change peak systolic acceleration. Beta blockade induced disparate changes of velocity and flow but reduced peak systolic acceleration (p less than 0.05). In the euthyroid state, decreased blood velocity (p less than 0.01), flow (p less than 0.02) and acceleration (p less than 0.02) were observed. A hyperkinetic arterial circulation consisting of an increase in both velocity and acceleration is thus observable in hyperthyroidism. Hand exclusion showed that velocity seems to be influenced by peripheral factors while beta blockade suggests that acceleration is dependent of beta 1 adrenoceptors. Comparison between euthyroidism and hyperthyroidism indicates that both mean blood velocity and peak systolic acceleration are influenced by thyroid hormones.

摘要

对10名甲状腺功能亢进患者和10名正常受试者的肱动脉血流模式进行了研究。通过脉冲多普勒评估平均血流速度和血流量,并通过计算机辅助数字化瞬时速度曲线计算收缩期峰值加速度。与对照组相比,甲状腺功能亢进患者的血流速度和血流量更高(p<0.01,p<0.02),收缩期峰值加速度也更高(p<0.01)。对甲状腺功能亢进患者在以下情况后重复进行测量:(1)通过机械方法使手部排除在肱动脉循环之外;(2)短期使用β受体阻滞剂治疗;(3)诱导甲状腺功能正常状态。排除手部后,血流速度和血流量降低(p<0.001),但收缩期峰值加速度未改变。β受体阻滞剂导致血流速度和血流量出现不同变化,但降低了收缩期峰值加速度(p<0.05)。在甲状腺功能正常状态下,观察到血流速度(p<0.01)、血流量(p<0.02)和加速度(p<0.02)均降低。因此,在甲状腺功能亢进症中可观察到一种由速度和加速度增加组成的动脉高动力循环。手部排除显示速度似乎受外周因素影响,而β受体阻滞剂提示加速度依赖于β1肾上腺素能受体。甲状腺功能正常与甲状腺功能亢进的比较表明,平均血流速度和收缩期峰值加速度均受甲状腺激素影响。

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