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血管迷走性晕厥患者倾斜试验中血浆内皮素 内皮舒张因子和心率变异性的研究 |
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吴林 丁燕生 徐学升 周菁 袁俊强 童琳 张钧华 任自文
【摘要】 目的 通过研究血管迷走性晕厥患者倾斜试验中血浆内皮源性血管活性物质和心率变异性的变化来了解自主神经及血管内皮功能在血管迷走性晕厥发生机制中的作用。方法 25例患者，倾斜试验阳性15例，阴性10例，于倾斜试验前和倾斜不同时间测定血浆内皮素（ET）、一氧化氮（NO）水平，采用动态心电图监测心率变异性的变化。结果 (1)倾斜试验阳性组出现阳性反应时血浆ET水平明显增高，高于倾斜前水平和倾斜试验阴性组(P<0.05和P<0.01)。(2)倾斜试验阳性组血浆NO水平在倾斜前、倾斜后10分钟和出现阳性反应各阶段均明显低于倾斜试验阴性组(P<0.05和P<0.01)；两组血浆NO水平分别在试验阳性时和试验终止时均高于倾斜前水平(P<0.05和P<0.01)。(3)倾斜试验阳性者出现阳性反应时，心率变异指标LF有明显下降(P<0.05)，HF也有下降。结论 血管内皮功能的调节异常和自主神经功能异常可能共同参与了血管迷走性晕厥的发生机制，两者可能存在相互作用。
【关键词】 晕厥 倾斜台试验 内皮缩血管肽类 心率变异性
Changes of plasma endothelin, EDRF and heart rate variability during the table tilt test in patients with vasovagal syncope
Wu Lin, Ding Yansheng, Xu Xuesheng, et al. Division of Cardiology, First Affiliated Hospital of Beijing Medical University, Beijing 100034
【Abstract】 Objective To evaluate the function of endothelium and autonomic nervous system in the pathogenesis of the vasovagal syncope. Methods The plasma level of endothelin (ET), endothelial derived releasing factor (EDRF-NO) and heart rate variability by Holter monitoring was measured in 25 patients before and at the different stages during the head-up tilt table testing (TTT). Among them, the TTT was positive in 15 and negative in 10. Results (1) The plasma ET level was increased significantly during syncope in patients with positive TTT compared with both their baseline and the level in patients with negative TTT (P<0.05 and 0.01, respectively). (2) The plasma NO level was significantly lower before TTT, at 10 minutes after and the end of TTT in patients with positive TTT than those in patients with negative TTT (P<0.05 and 0.01, respectively); the NO level also increased at the end of TTT compared with that before TTT in both groups. (3) The low frequency component was decreased during syncope compared with that at baseline level (P<0.05) in patients with positive TTT. Conclusion The abnormal function of vascula[1] [2] [3] 下一页
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