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[外科心脏外去神经支配的动物模型。心率自主控制的研究]

[An animal model of surgical, external cardiac denervation. Studies of the autonomic control of heart rate].

作者信息

Klossek H, Konkel J, Gehrig W

机构信息

Neurochirurgischen Abteilung, Bereichs Medizin, Ernst-Moritz-Arndt-Universität Greifswald.

出版信息

Zentralbl Chir. 1988;113(2):138-50.

PMID:3364052
Abstract

A great role is played in clinical practice by monitoring of vegetative functions, such as heart and respiratory rates. Mean values, rhythms, and interaction of both control variables in the form of respiratory sinus arrhythmia may provide plenty of information, primarily when computerised, and may enable conclusions to be drawn as to neuro-circulatory tonus. The model described in this paper has been devised for the purpose of producing information on types of changes in neurovegetative control in response to functional systemic effects from pharmaceuticals or from substantial, locally delimited lesions of nerve structures. External cardiac denervation is applied for stepwise discontinuation of sympathetic, parasympathetic, spinal, and medullary control systems up to the stage of cerebral death, resulting in cardiac "automatism". Data may thus be derived on the Bainbridge reflex, and correlations may be established with in vitro experiments on chronotropic control of the heart. The results presented in this paper may be of relevance to situations in intensive medical care or to cases with lesions to the central nervous system up to irreversible loss of brain function, when heart rate data recorded from monitoring of the central nervous system or of vegetative functions must be interpreted in all their variability with high reliability and accuracy for differential diagnosis and prognostication.

摘要

在临床实践中,对诸如心率和呼吸频率等自主功能的监测发挥着重要作用。呼吸性窦性心律不齐形式的两个控制变量的平均值、节律及其相互作用可能会提供大量信息,尤其是在进行计算机处理时,并且可能有助于得出关于神经循环张力的结论。本文所述模型的设计目的是为了获取有关神经自主控制变化类型的信息,这些变化是由药物的功能性全身作用或神经结构的实质性、局灶性损伤引起的。通过进行体外心脏去神经支配,逐步中断交感神经、副交感神经、脊髓和延髓控制系统,直至脑死亡阶段,从而产生心脏“自主性”。由此可以得出关于 Bainbridge 反射的数据,并与关于心脏变时性控制的体外实验建立相关性。本文所呈现的结果可能与重症监护中的情况相关,或者与中枢神经系统损伤直至脑功能不可逆转丧失的病例相关,此时必须以高度的可靠性和准确性对从监测中枢神经系统或自主功能记录的心率数据的所有变异性进行解释,以用于鉴别诊断和预后判断。

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