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正常血压和高血压患者的压力反射敏感性与心肺血容量

Baroreflex sensitivity and cardiopulmonary blood volume in normotensive and hypertensive patients.

作者信息

Simon A C, Safar M E, Weiss Y A, London G M, Milliez P L

出版信息

Br Heart J. 1977 Jul;39(7):799-805. doi: 10.1136/hrt.39.7.799.

Abstract

Baroreflex sensitivity and cardiopulmonary blood volume were determined in 95 men, including normotensive and hypertensive subjects with normal renal function and balanced sodium intake and urinary output. Baroreflex sensitivity was estimated by determining the slope of the regression line relating the increase of systolic pressure to the cardiac slowing after transient rises of arterial pressure. A technique of gradual atropinisation was used to evaluate the parasympathetic mediated component of the reflex. With this method, it was possible to calculate the exact atropine dose abolishing the reflex sensitivity. This index was not dependent on age. It was negatively correlated to the diastolic pressure in normotensive patients but not in hypertensive patients. The ratio between the cardiopulmonary and the total blood volume was considered as an index of sympathetic venous tone. This ratio was positively correlated to the diastolic pressure in normotensive patients, but not in hypertensive patients. This study strongly suggests that a precise sympathetic-parasympathetic balance existed in the normotensive patients. This balance was disrupted in the hypertensive patients pointing to abnormalities in the autonomic nervous system of permanently hypertensive patients.

摘要

对95名男性进行了压力感受性反射敏感性和心肺血容量的测定,这些男性包括血压正常和高血压患者,他们肾功能正常,钠摄入和尿量平衡。通过确定动脉压短暂升高后收缩压升高与心率减慢之间的回归线斜率来估计压力感受性反射敏感性。采用逐步阿托品化技术评估反射的副交感神经介导成分。用这种方法,可以计算出消除反射敏感性的确切阿托品剂量。该指标不依赖于年龄。在血压正常的患者中,它与舒张压呈负相关,但在高血压患者中并非如此。心肺血容量与总血容量的比值被视为交感神经静脉张力的指标。该比值在血压正常的患者中与舒张压呈正相关,但在高血压患者中并非如此。这项研究强烈表明,血压正常的患者存在精确的交感 - 副交感神经平衡。而高血压患者的这种平衡被打破,这表明持续性高血压患者的自主神经系统存在异常。

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本文引用的文献

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