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戒酒的酒精依赖者呼吸性窦性心律不齐的恢复情况。

Recovery of respiratory sinus arrhythmia in detoxified alcoholic subjects.

作者信息

Hirsch J A, Bishop B, York J L

机构信息

Research Institute on Addictions, Office of Alcoholism and Substance Abuse Services, Buffalo 14203.

出版信息

J Appl Physiol (1985). 1993 Apr;74(4):1816-23. doi: 10.1152/jappl.1993.74.4.1816.

Abstract

Although most alcoholic subjects show little autonomic dysfunction, severe alcoholic subjects may have pathological changes in autonomic nerves. We asked if respiratory sinus arrhythmia amplitude (RSA), an index of vagal cardiac control, is decreased in alcoholism and, if so, whether the decrease is reversed with abstinence. RSA was assessed in 17 normotensive alcoholic subjects (A) at 1, 4, 12, and 24 wk of abstinence after detoxification and at similar intervals in 17 controls (C) matched for age, race, and gender. Subjects were studied in both supine and seated positions while breathing in a prescribed deep (> 50% vital capacity) and slow (5-7/min) pattern. Mean heart rate (HR) was determined over 30 s from the electrocardiogram; RSA (the difference between maximum and minimum instantaneous HRs after inspiratory onset) was determined from 10 consecutive breaths. In C, both HR (supine: 61.5 +/- 2.2 beats/min; seated: 71.3 +/- 1.7 beats/min; P < 0.002) and RSA (supine: 22.5 +/- 1.0 beats/min; seated: 28.4 +/- 1.4 beats/min; P < 0.003) were higher when seated than when supine, but neither HR nor RSA varied over 24 wk. At week 1 of abstinence, HRs for A were higher than those for C (supine: 74.2 +/- 2.3 beats/min, P < 0.001; seated: 83.2 +/- 2.7 beats/min, P < 0.003), but by week 24, both seated and supine values returned to control levels. RSA in A at week 1, was only one-half that of C (supine: 11.1 +/- 1.4 beats/min, P < 0.001; seated: 14.7 +/- 1.9 beats/min, P < 0.001) and independent of body position.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

虽然大多数酗酒者几乎没有自主神经功能障碍,但严重酗酒者的自主神经可能会发生病理变化。我们探讨了作为迷走神经对心脏控制指标的呼吸性窦性心律不齐幅度(RSA)在酗酒者中是否降低,以及如果降低,戒酒后是否会恢复正常。对17名血压正常的酗酒者(A组)在解毒后戒酒1、4、12和24周时进行RSA评估,并在年龄、种族和性别相匹配的17名对照组(C组)的相似时间间隔进行评估。受试者在仰卧位和坐位时均按照规定的深呼吸(>肺活量的50%)和慢呼吸(5 - 7次/分钟)模式进行呼吸。通过心电图在30秒内测定平均心率(HR);从连续10次呼吸中测定RSA(吸气开始后最大和最小瞬时心率之间的差值)。在C组中,坐位时的HR(仰卧位:61.5±2.2次/分钟;坐位:71.3±1.7次/分钟;P<0.002)和RSA(仰卧位:22.5±1.0次/分钟;坐位:28.4±1.4次/分钟;P<0.003)均高于仰卧位,但HR和RSA在24周内均无变化。在戒酒第1周时,A组的HR高于C组(仰卧位:74.2±2.3次/分钟,P<0.001;坐位:83.2±2.7次/分钟,P<0.003),但到第24周时,坐位和仰卧位的值均恢复到对照水平。A组在第1周时的RSA仅为C组的一半(仰卧位:11.1±1.4次/分钟,P<0.001;坐位:14.7±1.9次/分钟,P<0.001),且与体位无关。(摘要截断于250字)

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