Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope
Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope
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DOI：
10.1136/hrt.75.2.134
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发表时间：
1996-02-01
期刊：
影响因子：
5.7
通讯作者：
Hainsworth, R
中科院分区：
文献类型：
--
作者：
ElSayed, H;Hainsworth, R
目的：探讨体位相关性晕厥患者服用盐是否能增加血浆容量并改善体位耐受性。体位应激耐受性差的患者血浆和血容量往往低于平均水平。设计一项针对20名患者的双盲安慰剂对照研究和一项针对11名患者给予120 mmol/d氯化钠效果的开放研究。患者：31例出现晕厥发作但无明显心脏或神经系统疾病的患者。血浆容量通过Evans蓝色染料稀释测定，直立耐受性通过联合俯仰和下体吸痰试验中晕厥前时间测定，压力感受器敏感性通过颈部吸痰对脉搏间隔的影响测定。结果：治疗8周后，21例盐组患者中15例（70%）和安慰剂组3例（30%）血浆和血容量增加，直立耐受性增加，压力感受器敏感性降低。改善与最初的盐排泄有关，对盐有反应的患者每天的盐排泄低于170 mmol。安慰剂组的患者也表现出盐排泄的增加。结论：对于盐摄入量相对较低的不明原因晕厥患者，在无禁忌症的情况下，盐可增加血浆容量和直立耐受性，建议作为一线治疗。
Objective-To determine whether in patients presenting with posturally related syncope administration of salt increases plasma volume and improves orthostatic tolerance. Patients with poor tolerance of orthostatic stress tend to have lower than average plasma and blood volumes.Design-A double blind placebo controlled study in 20 patients and an open study in 11 of the effects of giving 120 mmol/day of sodium chloride.Patients-31 patients presenting with episodes of syncope who had no apparent cardiac or neurological disease. Plasma volume was determined by Evans blue dye dilution, orthostatic tolerance by time to presyncope in a test of combined head-up tilt and lower body suction, and baroreceptor sensitivity by the effect of neck suction on pulse interval.Results-8 weeks after treatment, 15 (70%) of the 21 patients given salt and three (30%) of the placebo group showed increases in plasma and blood volumes and in orthostatic tolerance, and decreases in baroreceptor sensitivity. Improvement was related to initial salt excretion in that patients who responded to salt had a daily excretion below 170 mmol. The patients in the placebo group who improved also showed increases in salt excretion.Conclusions-In patients with unexplained syncope who had a relatively low salt intake administration of salt increased plasma volume and orthostatic tolerance, and in the absence of contraindications, salt is suggested as a first line of treatment.