心肌梗死中的循环反射
Circulatory reflexes in myocardial infarction.
作者信息
Kirby B J
出版信息
Br Heart J. 1977 Feb;39(2):168-72. doi: 10.1136/hrt.39.2.168.
Abstract
The Valsalva manoeuvre was used to examine circulatory reflexes in 22 patients with acute myocardial infarction. Four patients had the 'square wave' response of cardiac failure and two responded normally to the manoeuvre. In the remaining 18 patients there was a 20 per cent or more fall in pulse pressure during the manoeuvre, but no ensuing rise in diastolic pressure, implying impairment of vasoconstriction. This impairment cannot be explained by acidosis, hypocapnia, or arterial hypoxaemia but may be explained by reflex inhibition of vasoconstriction. This abnormal response has important implications when transporting patients; furthermore, it could explain the rapid deterioration sometimes seen in patients with arrhythmias.
摘要
采用瓦尔萨尔瓦动作对22例急性心肌梗死患者的循环反射进行检查。4例患者出现心力衰竭的“方波”反应，2例对该动作反应正常。其余18例患者在动作过程中脉压下降20%或更多，但舒张压随后未升高，提示血管收缩功能受损。这种损害不能用酸中毒、低碳酸血症或动脉血氧不足来解释，但可能是由于血管收缩的反射性抑制所致。这种异常反应在运送患者时具有重要意义；此外，它可以解释心律失常患者有时出现的快速病情恶化。
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