直立倾斜试验中心率功率谱密度及体液因素的变化  

The changes of heartrate power spectral density and humoral factors during head-up tilt test

作　　者：陈椿[1] 张馥敏[1] 黄元铸[1] 马文珠[1] 

机构地区：[1]南京医科大学第一附属医院心脏科,210029

出　　处：《中华心血管病杂志》1999年第1期36-38,共3页Chinese Journal of Cardiology

摘　　要：目的研究直立倾斜试验（ＨＵＴ）中的心率变异及体液因素的变化。方法６０例不明原因晕厥病人及２０例健康人在ＨＵＴ中作心率功率谱密度（ＨＲＰＳＤ）分析，并测定血浆去甲肾上腺素（ＮＥ）、肾素活性（ＲＡ）、血管紧张素Ⅱ（ＡｎｇⅡ）及醛固酮（ＡＬＤ）水平。结果倾斜前、后５分钟ＨＲＰＳＤ的总、超低频、低频、高频段功率谱密度、低／高频比和ＮＥ、ＲＡ、ＡｎｇⅡ、ＡＬＤ水平及其变化在阳性病人、阴性病人和正常对照三组均相似。试验结束前５分钟，阳性组的总、超低频、低频段功率谱密度、低／高频比显著高于阴性组和对照组（Ｐ＜０．０１）。试验结束时，阳性组的ＲＡ、ＡｎｇⅡ及ＡＬＤ显著高于阴性组和对照组（Ｐ＜０．０５），但三组间的ＮＥ差异无显著性。结论ＨＵＴ阳性的血管迷走性晕厥病人神经调节功能异常是晕厥的始发因素，体液调节是一种继发性代偿反应。Objective To study the changes of neural and humoral regulation during head-up tilt test(HUT). Methods The heart rate power spectral density (HRPSD) was analysed and the plasma levels ofnorepinephrine(NE), renin activity (RA), angiotension-Ⅱ (Aug Ⅱ) and aldosterone (ALD) were measured in 60patients with unexplained syncope and in 20 healthy subjects. Results The data and their changes of HRPSD intotal, very low-frequency, low-frequency, high-frequency and the ratio of low-high frequency and plasma NE,RA, AngⅡ, ALD were similar among positive patients, negative patients and conrols in 5 minutes before andafter tilting. Five minutes before the end of test, the HRPSD in total, very low-frequency, low-frequency and theratio of low-high frequency were significantly higher in the positive group than in the negative and control ones(P<0.01). At the end of HUT, plasma RA, AngⅡ and ALD were significantly higher in positiv group than innegative and control ones (P<0.05), but there were no sigificant differences in NE in all three groups.Conchusion The results suggest that the abnormal regulatory function of autonomic nervous system might be thetrigger factor for syncope induced by HUT, the humoral regulation might be a secondary compensating response.

关 键 词：晕厥 直立倾斜试验 心率功率谱 

分 类 号：R544.204[医药卫生—心血管疾病]