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Chagas 病患者对胰岛素和脂肪乳剂输注的血压、代谢和自主反应。

Blood pressure, metabolic and autonomic responses to insulin and intralipid® infusion in chagasic patients.

机构信息

Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil.

出版信息

Arq Bras Cardiol. 2012 Mar;98(3):225-33. doi: 10.1590/s0066-782x2012005000018. Epub 2012 Feb 29.

Abstract

BACKGROUND

Intralipid(®) and heparin infusion results in increased blood pressure and autonomic abnormalities in normal and hypertensive individuals.

OBJECTIVE

To evaluate insulin sensitivity and the impact of Intralipid(®) and heparin (ILH) infusion on hemodynamic, metabolic, and autonomic response in patients with the indeterminate form of Chagas' disease.

METHODS

Twelve patients with the indeterminate form of Chagas' disease and 12 healthy volunteers were evaluated.

RESULTS

Baseline blood pressure and heart rate were similar in both groups. Plasma noradrenaline levels were slightly increased in the Chagas' group. After insulin tolerance testing (ITT), a significant decline was noted in glucose in both groups. ILH infusion resulted in increased blood pressure in both groups, but there was no significant change in plasma noradrenaline. The low-frequency component (LF) was similar and similarly increased in both groups. The high-frequency component (HF) was lower in the Chagas' group.

CONCLUSION

Patients with the indeterminate form of Chagas' disease had increased sympathetic activity at baseline and impaired response to insulin. They also had a lower high-frequency component and impaired baroreflex sensitivity at baseline and during Intralipid(®) and heparin infusion.

摘要

背景

脂肪乳(®)和肝素输注会导致正常人和高血压个体的血压升高和自主神经异常。

目的

评估胰岛素敏感性以及脂肪乳(®)和肝素(ILH)输注对恰加斯病不确定型患者的血流动力学、代谢和自主神经反应的影响。

方法

评估了 12 例恰加斯病不确定型患者和 12 例健康志愿者。

结果

两组的基础血压和心率相似。恰加斯组的去甲肾上腺素水平略有升高。胰岛素耐量试验(ITT)后,两组的血糖均显著下降。ILH 输注使两组的血压均升高,但去甲肾上腺素无明显变化。低频成分(LF)在两组中相似且均增加。恰加斯组的高频成分(HF)较低。

结论

恰加斯病不确定型患者的基础自主神经活动增加,对胰岛素的反应受损。他们在基线和脂肪乳(®)和肝素输注期间也具有较低的高频成分和受损的压力反射敏感性。

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