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古特隆对原发性直立性低血压患者的治疗。第二部分——自主神经系统研究。

Gutron treatment of patients suffering from essential orthostatic hypotony. Part Two--Autonomic system investigation.

作者信息

Petelez T, Sosnowski M, Axenti I

机构信息

III Clinic of Cardiology, Silesian Academy of Medicine, Katowice, Poland.

出版信息

Int Angiol. 1993 Jun;12(2):138-44.

PMID:7690385
Abstract

Neurovegative control of circulatory system in essential orthostatic hypotony (EOH) is not well recognized. Therefore, in group of 9 patients (pts) with EOH treated with midodrine (Gutron, Gu) 5 mg i.v. we performed a study of sympathovagal balance, based on heart rate variability (HRV) analysis. From computer-assisted tachograms we calculated standard deviation of 512 sinus cycles length (SD-SCL) and from power spectral analysis by fast Fourier transformation we derived: amplitudes of high frequency (HF, 0.15-0.35 Hz) and low frequency (LF, 0.05-0.15 Hz) spectra, percentage of power of HF and LF spectra and their ratio, named vegetative control coefficient (VCC, %LF:%HF). Results were compared to that received from control group (11 volunteers). We found that EOH-pts presented lower amplitude of HF, especially after Gu, a lack of increment of %LF irrespective to treatment and higher VCC, which normalized to control value after Gu. We stated that: 1) both branches of autonomic system are disturbed in EOH-patients; 2) Gutron shifts sympatho-vagal balance from initial resting sympathicotomy into parasympathetic predominance.

摘要

原发性直立性低血压(EOH)中循环系统的神经调节控制尚未得到充分认识。因此,在9例接受米多君(古特龙,Gu)5mg静脉注射治疗的EOH患者中,我们基于心率变异性(HRV)分析进行了交感迷走神经平衡研究。从计算机辅助心动图中,我们计算了512个窦性周期长度的标准差(SD-SCL),并通过快速傅里叶变换进行功率谱分析得出:高频(HF,0.15 - 0.35Hz)和低频(LF,0.05 - 0.15Hz)谱的振幅、HF和LF谱功率的百分比及其比值,即自主神经控制系数(VCC,%LF:%HF)。将结果与对照组(11名志愿者)的结果进行比较。我们发现EOH患者的HF振幅较低,尤其是在使用Gu后,无论治疗与否,%LF均无增加,且VCC较高,使用Gu后其恢复至对照值。我们指出:1)自主神经系统的两个分支在EOH患者中均受到干扰;2)古特龙将交感 - 迷走神经平衡从初始的静息交感神经切断状态转变为副交感神经占优势状态。

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