本態性高血圧症における血管運動中枢異常に関する研究

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Author: 森瀬, 敏夫ほか

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Publication date: 1999-03-15

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Note (General)：: 金沢大学附属病院「目的」本態性高血圧症の病因については脳幹に存在する血管運動中枢そのものに異常がある可能性に着目し検討した。「方法」本態性高血圧症患者(EHT)23名、二次性高血圧症患者(SHT)13名、正常血圧者(NT)46名を対象とした。MRTはT-2強調およびMRangioを用いて評価した。心...

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Material Type: 文書・図像類
Title: 本態性高血圧症における血管運動中枢異常に関する研究
Author/Editor: 森瀬, 敏夫
Morise, Toshio
Author Heading: 森瀬, 敏夫
Morise, Toshio
Publication Date: 1999-03-15
Publication Date (W3CDTF): 1999-03-15
Alternative Title: Heart rate variability and neurovascular compression in essential hypertension.
Periodical title: 平成9(1997)年度科学研究費補助金基盤研究(C) 研究成果報告書概要 = 1997 Fiscal Year Final Research Report Summary
No. or year of volume/issue: 1996 – 1997
Volume: 1996 – 1997
Pages: 2p.-
Text Language Code: jpn
Subject Heading: 高血圧
血管運動中枢
心拍変動
Hypertension
Vasomator
Power spectrum
Target Audience: 一般
Note (General): 金沢大学附属病院
「目的」本態性高血圧症の病因については脳幹に存在する血管運動中枢そのものに異常がある可能性に着目し検討した。「方法」本態性高血圧症患者(EHT)23名、二次性高血圧症患者(SHT)13名、正常血圧者(NT)46名を対象とした。MRTはT-2強調およびMRangioを用いて評価した。心拍変動のスペクトル解析は心電図からのanalogデータをA-Dconverter(I.O.data)を用いて500Hzでデジタル化したうえで記録し、連続した256心拍分を高速フーリエ解析にて検討した。以上のソフトウェアは国立石川高等工業専門学校堀田および申請者により作成された。「結果」血管運動中枢の圧迫はEHTでは23例中16(70%)例で、SHT患者では13例中一例もなく、NTでは45例中7(16%)例で認められ、血管運動中枢の圧迫はEHTで有意に高頻度であった(p<0.001)。交感神経の指標であるLow frequencyの年齢補正パワースペクトラムデンシティ(A-PSD)は血管運動中枢の圧迫を伴うEHTでは139.5±6.7%、血管運動中枢の圧迫のないEHTでは92.2±6.8%、血管運動中枢の圧迫を伴うNTでは102.8±13.0%、血管運動中枢の圧迫のないNTでは100.1±4.1%、SHT95.7±10.2%と血管運動中枢の圧迫を伴うEHTで有意に(p<0.001)高値であった。副交感神経の指標であるhigh-frequency A-PSD(HF:0.15-0.40Hz)では各群間に差は無かった。「結論」EHTではSHT及びNTと比較して有意に高頻度に血管運動中枢の圧迫が観察された。血管運動中枢の圧迫は何らかのfactorにより交感神経活動の亢進を伴う場合とそうでない場合があり、亢進を伴うとき本態性高血圧症を発祥するものと推測された。
There are physiological and anatomical reasons to suspect that neurovascular compression of the rostral ventrolateral medulla (RVLM) may cause essential hypertension. Clinical studies using magnetic resonance tomography (MRT) have found that neurovascular compression of the RVLM is related to essential hypertension. However, the mechanism of a neurovascular compression-induced increase in blood pressure has not been investigated in a clinical study.Methods We investigated the neurovascular compression-induced increase in 23 patients with essential hypertension (EHT), 13 patients with secondary hypertension (SHT), and 46 normotensive subjects (NT). Neurovascular compression was evaluated by MRT.We determined the power spectral components of heart rate variability as indices of autonomic nerve tone to investigate the possibility that sympathetic tone mediates the neurovascular compression-induced increase in blood pressure. The power spectral density was calculated by fast Fourier transform in a series of 256 consecutive and stationary cardiac interval.Findings Neurovascular compression of the RVLM was observed in 70% of EHT,none of SHT and 16% of NT (p<0.001). The age-adjusted low-frequency power spectral density (A-PSD), which is an index of sympathetic tone, was significantly higher in patients with EHT (139.5%) with neurovascular compression than in EHT without neurovascular compression (92.2%), NT with (102.8%) and without neurovascular compression (100.1%), and patients with SHT (95.7%) (p<0.001). There was no significant difference in the high-frequency A-PSD (0.15 to 0.40 Hz), which is an index of vagal tone, among groups.Interpretation Neurovascular compression, assessed by MRT,was not always associated with an increase in sympathetic nerve tone. Hypertension was present in subjects with neurovascular compression, who had increased sympathetic tone but not in those with normal sympathetic tone. The present findings confirm that essential hypertension is associated with neurovascular compression and suggest that an increase in sympathetic tone may mediate the neurovascular compression-induced increase in blood pressure.
研究課題/領域番号:08670515, 研究期間(年度):1996 – 1997
出典：研究課題「本態性高血圧症における血管運動中枢異常に関する研究」課題番号08670515（KAKEN：科学研究費助成事業データベース（国立情報学研究所））（https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-08670515/086705151997kenkyu_seika_hokoku_gaiyo/）を加工して作成
DOI: 10.24517/00066143
Access Restrictions: 限定公開
Related Material: https://kaken.nii.ac.jp/search/?qm=40191027
https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-08670515/
https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-08670515/086705151997kenkyu_seika_hokoku_gaiyo/
Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）
https://irdb.nii.ac.jp
Original Data Provider (Database): 金沢大学 : 金沢大学学術情報リポジトリKURA