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日常活动期间动脉压力反射变化的敏感性。

Sensitivity of arterial baroreflex changes during daily activity.

作者信息

Yamamoto Y, Takabatake T, Nakamura S, Hashimoto N, Satoh S, Yamada Y, Ohta H, Hattori N

机构信息

First Department of Internal Medicine, School of Medicine, Kanazawa University, Japan.

出版信息

Clin Exp Pharmacol Physiol Suppl. 1989;15:113-6. doi: 10.1111/j.1440-1681.1989.tb03005.x.

Abstract
  1. Continuous ambulatory arterial pressure monitoring was performed by telemetry in 34 hypertensive and four normotensive subjects and arterial baroreflex sensitivity was evaluated by computer analysis of pulse wave. Three consecutive pulses were selected, on two criteria, from the 24 h recording: (i) progressive and linear increase or decrease in systolic arterial pressure and heart period, (ii) change of systolic arterial pressure in three pulses exceeds a threshold value. The systolic arterial pressure and heart period of three pulses were averaged and the slopes of systolic arterial pressure and heart period were calculated as baroreflex sensitivity. 2. When the threshold value was set to 5 mmHg, baroreflex sensitivity measured by the present method correlated with baroreflex sensitivity as measured by the phenylephrine method (r = 0.667, P less than 0.001). 3. The baroreflex sensitivity from the pressor-bradycardia and the depressor-tachycardia reflex decreased as threshold value was increased from 3 to 4 mmHg to over 20 mmHg. With the pressor-bradycardia reflex, the initial systolic arterial pressure of three pulses did not change, but the initial heart period shortened progressively as the threshold increased. With the depressor-tachycardia reflex, the initial systolic arterial pressure increased and the initial heart period shortened progressively. This suggests that the sensitivity of arterial baroreflex changes dynamically according to input of reflex are during daily activity.
摘要
  1. 对34名高血压患者和4名血压正常者采用遥测法进行动态动脉血压监测,并通过脉搏波的计算机分析评估动脉压力反射敏感性。从24小时记录中按两个标准选择三个连续的脉搏:(i)收缩压和心动周期呈渐进性线性增加或减少,(ii)三个脉搏中收缩压的变化超过阈值。计算这三个脉搏的平均收缩压和心动周期,并将收缩压和心动周期的斜率作为压力反射敏感性进行计算。2. 当阈值设定为5 mmHg时,用本方法测得的压力反射敏感性与用去氧肾上腺素法测得的压力反射敏感性相关(r = 0.667,P < 0.001)。3. 随着阈值从3 mmHg增加到4 mmHg再到超过20 mmHg,升压-心动过缓反射和降压-心动过速反射的压力反射敏感性降低。对于升压-心动过缓反射,三个脉搏的初始收缩压不变,但随着阈值增加,初始心动周期逐渐缩短。对于降压-心动过速反射,初始收缩压升高,初始心动周期逐渐缩短。这表明在日常活动期间,动脉压力反射的敏感性根据反射弧的输入而动态变化。

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