DETERMINATION OF A NEW CRITERIA FOR ORTHOSTATIC DYSREGUATION

确定直立性失调的新标准

• 批准号: 07670917
• 负责人: TANAKA Hidetaka
• 金额: $ 1.15万
• 依托单位: OSAKA MEDICAL COLLEGE
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1996
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07670917/
• 关键词: Orthostatic dysregulation; Orthostatic test; Diagnostic criteria; orthostatic hypotenion; Adolescents; Orthostatic dizziness; FINAPRES; continuous blood pressure measurments

We determined the criteria for instantaneous orthostatic hypotension (INOH), a typical form of orthostatic dysregulation, from the reference data of 173 healthy children, aged 6 to 18 years. Also reported were clinical characteristics, circulatory and catecholamine responses to postural change in 44 children and young adults with instantaneous orthostatic hypotension (INOH) compared with 73 age matched controls. The criteria for INOH was as follows : group I (mild type), a 60% or greater decrease in mean blood pressure during the initial phase of standing, or blood pressure recovery time of more than 25 sec evaluated by a non-invasive finger arterial pressure monitoring system ; group II (severe type), prolonged reduction in systolic arterial pressure of more than 15% during the later stage of standing in addition to the criteria for group I.Sensitivity and specificity of this criteria were as high as 100% and 90.4%, respectively. Group I and group II showed significantly more pronounc … More ed reduction in BP) than normal controls at the initial drop (% reduction for systolic BP : -53+-12, -50+-6 vs.-32+-16, respectively, p<0.001), one minute of standing (-6+-10, -24+-18 vs.6+-12, p<0.001) and five minute of standing (-5+13, -21+-11 vs.8+-9, p<0.05). Plasma noradrenaline responses to standing were significantly lower in group I and group II than in controls after one minute of standing (50+-63,33+-39 vs.99+-56 pg/ml, respevtively), and were kept lower in group II after five minutes (218+-122,115+-78 vs.193+-98 pg/ml, respectively). The physical complaints included chronic fatigue (91% of the patients), orthostatic dizziness (88%), weakness (84%), sleep disturbance (73%), syncope or near syncope (68%), headache (68%), loss of apprtite (57%), abdominal pain (55%). Among these complaints chronic fatigue, loss of appetite, orthostatic dizziness, syncope and morning tiredness were specific for INOH.These results suggest that mechanisms responsible for INOH may depend on reduced noradrenaline secretion during orthostatic stress, associated with centrally mediated sympathetic inhibition. The patients in group II seemed to have more decreased sympathetic activation and thus more impaired quality of life than those in group I including school absenteeism. INOH is an important pathological condition in children with complaints of orthostatic intolerance and chronic fatigue. This can be identified when using a non-invasive beat-to-beat continuous blood pressure monitoring system. Less

我们根据173名6至18岁的健康儿童的参考证明，确定了瞬时性4STORPONATIC低血压（INOH）的标准（INOH）。还报道了44名患有瞬时44岁儿童和年轻人的临床特征，回路和儿茶酚胺对姿势变化的反应（INOH），而年龄匹配的对照组为73个。 INOH的标准如下：I组（轻度类型），在站立的初始阶段的平均血压降低60％或更高，或通过非侵入性手指动脉压力监测系统评估的25秒以上的血压恢复时间； II组（严重类型），除了组的标准和该标准的特异性之外，在站立的后期，收缩压的长期降低超过15％，分别高达100％和90.4％。第一组和第二组的BP显示出比正常对照的降低更明显的降低（收缩期BP的降低％降低％：-53+-12，-50+-6 vs.-32+-16，p <0.001），站立的一分钟（-6+-10，-10，-24+-18 VS.6+-18 VS.6+-18 VS.6+-112，p <0.001） -21+-11 vs.8+-9，p <0.05）。 I组和II组对站立的血浆肾上腺素反应明显低于站立后一分钟后的对照组（50+-63,33+-39+-39+-56+-56 pg/ml，纵横内），五分钟后II组在II组中保持较低（218+-122,115+-122,115+-78 VS.193+-93+-98 PG/ML，身体上的抱怨包括慢性疲劳（91％的患者），体位性头晕（88％），弱点（84％），睡眠障碍（73％），晕厥或附近的晕厥（68％），头痛（68％），倾向（57％），腹痛（55％）。在这些抱怨中，慢性疲劳，食欲不振，体位性头晕，晕厥和晨性疲劳是特异性的。这些结果表明，负责INOH的机制可能取决于在体位应激过程中与肾上腺素分泌减少，这与中央介导的交感神经抑制有关。 II组中的患者似乎比包括学校缺勤的I组更高级同情激活，因此生活质量更大。 INOH是患有体位耐肠和慢性疲劳的儿童的重要病理状况。当使用非侵入性跳动连续血压监测系统时，可以确定这一点。较少的

项目成果

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