具有不同盐敏阈值和自主音调类型的学生的血液动力学参数:一项观察性队列研究

I. A. Chastoyedova
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In the formed groups, a comparative analysis of hemodynamic parameters was carried out. At the second stage of the study, after assessing the initial autonomic tone, three groups were identified: group 1 (n = 40) — students with equilibrium of the sympathetic and parasympathetic systems (normotension); group 2 (n = 104) — students with dominating parasympathetic regulation of the heart rhythm (vagotonia); group 3 (n = 22) — students with dominating sympathetic regulation of the heart rhythm (sympathicotonia). Hemodynamic parameters were also studied in these groups. Statistical data processing was carried out using Statistica Advanced 10 for Windows RU. The differences between the comparison groups were assessed using parametric Student’s t-test and non-parametric Mann-Whitney U-test.Results. A high threshold of salt sensitivity was revealed in 23% of students. When comparing hemodynamic parameters in the groups, it was found that students with high thresholds of salt sensitivity had significantly higher values of systolic blood pressure, diastolic blood pressure, pulse pressure and average hemodynamic pressure than students with a low threshold. Differences in hemodynamics in students may be caused by differences in the original autonomic tone. Thus, students with vagotonia, if compared to those with normotension, have significantly lower values of heart rate, cardiac minute output, double product, and circulatory efficiency ratio, but a higher value of the peripheral vascular resistance. Students with sympathicotonia have statistically higher heart rate, cardiac minute output, and double product values.Conclusion. 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引用次数: 0

摘要

背景血液动力学参数与盐敏感性阈值和初始自主神经张力类型相关。关于这种关系的现有数据不足。目的:确定不同盐敏感性阈值和自主神经张力类型的学生的血液动力学参数和特征。方法。这项研究招募了基洛夫州立医科大学174名二年级学生,年龄在18-23岁之间,他们同意这项调查。这项研究历时四个月,包括两个阶段。在第一阶段,对所有参与者的盐敏感性阈值进行评估。根据结果,分为两组:A组——盐敏阈值正常的学生(n=127);B组——具有高盐敏感性阈值的学生(n=39)。在形成的组中,对血液动力学参数进行比较分析。在研究的第二阶段,在评估了最初的自主神经张力后,确定了三组:第1组(n=40)——交感神经和副交感神经系统平衡的学生(血压正常);第2组(n=104)——具有支配性副交感神经调节心律的学生(迷走神经缺乏症);第3组(n=22)——具有支配性交感神经调节心律的学生(交感神经强直)。还对这些组的血液动力学参数进行了研究。使用Statistica Advanced 10 for Windows RU进行统计数据处理。使用参数Student t检验和非参数Mann-Whitney U检验评估比较组之间的差异。结果。23%的学生出现高盐敏感性阈值。在比较各组的血液动力学参数时,发现盐敏感性阈值高的学生的收缩压、舒张压、脉压和平均血液动力学压力值明显高于阈值低的学生。学生血流动力学的差异可能是由原始自主神经音调的差异引起的。因此,与血压正常的学生相比,迷走神经缺乏的学生的心率、每分钟输出量、双乘积和循环效率比明显较低,但外周血管阻力值较高。从统计数据来看,患有交感神经痛的学生心率、每分钟心输出量和双乘积值较高。结论通过评估健康年轻人的血液动力学参数与盐敏感性阈值和初始自主神经张力的关系,可以评估高血压发展的风险因素,确定高血压前期(正常血压高),并制定旨在减少心血管系统疾病数量的预防计划。
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Hemodynamic Parameters in Students with Different Thresholds of Salt Sensitivity and Type of Autonomic Tone: An Observational Cohort Study
Background. Hemodynamic parameters are interrelated with both the threshold of salt sensitivity and the type of initial autonomic tone. Available data on such relationships are insufficient. Objective — to identify the hemodynamic parameters and features in students with different thresholds of salt sensitivity and types of autonomic tone.Methods. The study enrolled 174 second-year students of Kirov State Medical University, aged 18–23, who gave consent to the survey. The study was conducted over a period of four months and included two stages. At the first stage, all participants were evaluated for the threshold of salt sensitivity. According to the results, two groups were formed: group A — students with a normal threshold of salt sensitivity (n = 127); group B — students with a high threshold of salt sensitivity (n = 39). In the formed groups, a comparative analysis of hemodynamic parameters was carried out. At the second stage of the study, after assessing the initial autonomic tone, three groups were identified: group 1 (n = 40) — students with equilibrium of the sympathetic and parasympathetic systems (normotension); group 2 (n = 104) — students with dominating parasympathetic regulation of the heart rhythm (vagotonia); group 3 (n = 22) — students with dominating sympathetic regulation of the heart rhythm (sympathicotonia). Hemodynamic parameters were also studied in these groups. Statistical data processing was carried out using Statistica Advanced 10 for Windows RU. The differences between the comparison groups were assessed using parametric Student’s t-test and non-parametric Mann-Whitney U-test.Results. A high threshold of salt sensitivity was revealed in 23% of students. When comparing hemodynamic parameters in the groups, it was found that students with high thresholds of salt sensitivity had significantly higher values of systolic blood pressure, diastolic blood pressure, pulse pressure and average hemodynamic pressure than students with a low threshold. Differences in hemodynamics in students may be caused by differences in the original autonomic tone. Thus, students with vagotonia, if compared to those with normotension, have significantly lower values of heart rate, cardiac minute output, double product, and circulatory efficiency ratio, but a higher value of the peripheral vascular resistance. Students with sympathicotonia have statistically higher heart rate, cardiac minute output, and double product values.Conclusion. The assessment of hemodynamic parameters in healthy young people in relation to the threshold of salt sensitivity and the initial autonomic tone enables the risk factors for the development of hypertension to be assessed, prehypertension (high normal blood pressure) to be identified, and preventive programs aimed at reducing the number of diseases of the cardiovascular system to be developed.
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