体位改变对压力反射敏感性的影响  

The Influence of Posture Alteration on Baroreflex Sensitivity

作　　者：李立帅[1] 辛继宾[1] 李程[1] 方勇[1] 张帆[1] 蒋雨平[2] 吴国强[3] 

机构地区：[1]复旦大学上海医学院神经病学系,200032 [2]复旦大学附属华山医院神经科,200040 [3]复旦大学力学与工程科学系,200433

出　　处：《中国临床神经科学》2006年第1期6-10,共5页Chinese Journal of Clinical Neurosciences

基　　金：国家自然科学基金(编号30370353);复旦大学本科生学术资助计划的资助

摘　　要：目的:探讨帕金森病(PD)患者的压力反射敏感性(BRS)的受损及体位改变的影响。方法:对正常青年组13名,正常老年组11名,PD组16例,采用频谱分析的方法检测仰卧(supine)和头高位倾斜(HUT,+75°)时的心率变异性(HRV)和BRS值。结果:Supine在PD组BRS较青年组低(P<0.05);HUT后各组BRS均降低(P<0.05),且各组之间的差异显著,青年组、老年组、PD组依次降低(P<0.05)。结论:体位改变使BRS值降低;PD患者的心血管反射受损;BRS及体位改变测试是PD患者自主神经功能损害的敏感指标。Aim： To discuss cardiovascular regulation of autonomic nervous system and impairment of baroreflex sensitivity （BRS） for Parkinson＇s patients （PD） with head-up tilt （HUT）. Methods： 13 health young subjects, 11 normal elders and 16 PD patients were enrolled in measurements. HRV ＆ BRS non- invasive measurement system （typed SMUP-E） was used. Spectral analysis was applied to measure HRV and BRS in the supine posture and HUT （ ＋ 75°） . Results： ①LF/HF ratio in HRV of young group increased significantly in HUT compared with in supine posture. ②In supine position, BRS of PD group were lower than that of normal young group （P 〈 0.05）. ③BRS of all groups were decreased in HUT （P 〈 0.05） ,and the differences between groups were more remarkable. ④With HUT, BRS of normal elder group were lower than that of normal young group （ P 〈 0.05） ; the BRS values of PD group were lower than that of normal elder group （P 〈 0.05）. Conclusion： BRS and its change with posture alteration are more sensitive indices than HRV to examine the function of autonomic nervous system, especially for PD patients. The decrease of BRS, both in supine and HUT, indicated the impairment of autonomic regulation for PD patients.

关 键 词：心率变异性 压力反射敏感性 自主神经系统 帕金森病 

分 类 号：R742.5[医药卫生—神经病学与精神病学] R741.04[医药卫生—临床医学]