血浆β-内啡肽升高先于血管减压性晕厥。

Increase in plasma beta endorphins precedes vasodepressor syncope.

作者信息

Wallbridge D R, MacIntyre H E, Gray C E, Denvir M A, Oldroyd K G, Rae A P, Cobbe S M

机构信息

Department of Medical Cardiology, Royal Infirmary, Glasgow.

出版信息

Br Heart J. 1994 Jun;71(6):597-9. doi: 10.1136/hrt.71.6.597.

DOI:10.1136/hrt.71.6.597

PMID:8043346

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1025463/

Abstract

BACKGROUND

Endogenous opioids have a tonic inhibitory effect on sympathetic tone and have been implicated in the pathophysiology of vasodepressor syncope. Plasma beta endorphin concentrations increase after vasodepressor syncope induced by exercise or by fasting.

AIMS

To take frequent samples for plasma beta endorphin estimation during tilt testing, and to determine whether plasma beta endorphin increased before the start of syncope.

PATIENTS

24 patients undergoing tilt testing for investigation of unexplained syncope.

SETTING

Tertiary referral centre.

METHODS

Blood samples were obtained during 70 degrees head up tilt testing. Plasma beta endorphin concentrations were estimated by radioimmunoassay (mean(SD) pmol/l).

RESULTS

Patients with a positive test showed a rise in beta endorphin concentrations before syncope (baseline 4.4(1.5) v start of syncope 8.5(3.1), p < 0.002). In contrast, patients with a negative test showed no change in beta endorphin concentrations (baseline 3.4(1.0) v end of test 4.5(2.3), NS). After syncope all patients showed a large secondary increase in beta endorphins (32.3(18.6)).

CONCLUSION

An increase in plasma beta endorphins precedes vasodepressor syncope. This finding supports a pathophysiological role for endogenous opioids.

摘要

背景

内源性阿片肽对交感神经张力具有持续性抑制作用，并与血管减压性晕厥的病理生理学有关。运动或禁食诱发血管减压性晕厥后，血浆β-内啡肽浓度会升高。

目的

在倾斜试验期间频繁采集血样以测定血浆β-内啡肽，并确定血浆β-内啡肽在晕厥开始前是否升高。

患者

24例因不明原因晕厥接受倾斜试验的患者。

地点

三级转诊中心。

方法

在70度头高位倾斜试验期间采集血样。采用放射免疫分析法测定血浆β-内啡肽浓度（单位：pmol/l，均值（标准差））。

结果

试验阳性的患者在晕厥前β-内啡肽浓度升高（基线值4.4（1.5）对比晕厥开始时8.5（3.1），p<0.002）。相比之下，试验阴性的患者β-内啡肽浓度无变化（基线值3.4（1.0）对比试验结束时4.5（2.3），无显著性差异）。晕厥后所有患者的β-内啡肽均出现大幅继发性升高（32.3（18.6））。