Effects of reflex circulatory regulation on cardiac morbidity and mortality: influences of gender and menstrual cycle

(1)性别和月经周期对心迷走神经压力感受性反射功能的影响我们用颈腔法测定了14例健康女性在卵泡早期、排卵前期和黄体中期的心迷走神经压力反射反应，并与健康男性对照。我们发现：(1)在卵泡早期和黄体中期，巴氏反射敏感性低于男性志愿者，而在排卵前期与男性相似。此外，女性血浆雌二醇浓度与心迷走神经压力反射敏感性呈正相关。(2)性别对全麻前和全麻术中心迷走神经压力反射功能的影响采用颈室法和快速傅立叶变换法检测了15名健康女性的心迷走神经压力反射反应和心率变异性，并与男性志愿者的结果进行了比较。我们有Foun…在清醒和七氟醚麻醉状态下，男性压力感受性反射敏感性和心率变异性各项指标SDNN、PNN50和RMSSD均大于女性。(3)用颈室法观察了α2肾上腺素能激动剂α2肾上腺素能激动剂地塞米松25μg/kg iv对七氟醚麻醉中和七氟醚麻醉后心迷走神经压力反射反应的影响。我们发现，在全麻诱导前，地塞米定增强了压力反射敏感性，但这种作用在七氟醚麻醉期间和之后被取消，表明七氟醚对迷走神经活动的抑制大于α2肾上腺素能激动剂地塞米丁对迷走神经活动的增强。(4)由于这部分研究分配的患者数量不足，围手术期迷走神经活动与心脏发病率和死亡率的相关性，在重症监护病房患者中，迷走神经功能与心脏发病率和死亡率的关系尚未得出明确结论。较少

(1) Effects of gender and menstrual cycle on cardiovagal baroreflex function We examined cardiovagal baroreflex responses using Neck-Chamber method in 14 healthy female subjects during the early follicular, pre-ovulation and mid-luteal phases, and compared the results with healthy male subjects. We found that (1) baaroreflex sensitivities during the early follicular and mid-luteal phases were less than male volunteers, while that of the pre-ovulation phase was similar to that of male subjects. In addition, plasma estradiol concentration was correlated positively with cardovagal baroreflex sensitivity in female subjects.(2) Effects of gender on cardiovagal baroreflex function before and during general anesthesia Cardiovagal baroreflex responses using the Neck-Chamber method and heart rate variability using the fast Fourier transformation were determined in 15 healthy female subjects irrespective of the menstrual cycle, and compared the results with those of male volunteers. We have foun … More d that baroreflex sensitivity and various indices of heart rate variability, such as SDNN, pNN50 and RMSSD, were all greater in male than female subjects in awake and sevoflurane-anesthetized states.(3) Effects if α2-adrenergic agonist on cardiovagal baroreflex function during and after general anesthesia Effects of α2-adrenergic agonist, dex-medetomidine 25 μg/kg iv, on cardiovagal baroreflex responses by the Neck-Chamber method were determined in 12 healthy male subjects during and after sevoflurane anesthesia. We found that dex-medetomidine augmented baroeflex sensitivity before induction of general anesthesia, but this effect was abolished during and after sevoflurane anesthesia, indicating that sevoflurane-induoed depression of the vagal nerve activity is greater than vagal nerve augmentation by the α2-adrenergic agonist, dex-medetomidine.(4) Correlation between perioperative vagal nerve activity versus cardiac morbidity and mortality Because of inadequate number of patients assigned in this part of the study, no definitive conclusion was drawn in terms of the relationship between perioperative vagal nerve function versus cardiac morbidity and mortality in the intensive care unit patients. Less