不同模式反复体位改变对人体心血管调节功能的影响

发布时间：2018-02-16 16:21

本文关键词： 反复体体位改变试验心血管调节心血管参数心血管反应卧位个体位生理指标心血管效应自主神经系统 　出处：《空军医学杂志》2016年06期 　论文类型：期刊论文

【摘要】：目的对同一组受试人群实施2种不同模式的反复体位改变刺激,通过比较试验前、后及试验中多项生理指标的变化,阐明2种反复体位改变对心血管影响的差异及应用方向。方法对12名健康男性进行不同模式的反复体位改变试验,并在试验前、后5min对受试者进行5min+75°的心血管反应测试(HUT)。以平卧位参数为对照,取受试者在每个体位第20、60s时的心率(HR)、血压(SBP,DBP,MBP)、每搏量(SV)、心输出量(CO)、总外周阻力(TPR)等指标进行分析。结果(1)HDT/HUT模式的试验可使受试者在之后的HUT检查时心血管反应指数(CRI)升高(P0.01),平卧位时的SV、CO显著低于试验前,TPR显著升高;DBP、MBP、CO在HUT1min时较试验前显著下降,TPR显著上升,SV在立位时有下降趋势。SUP/HUT模式的试验使之后的HUT检查时平卧位的HR、CO下降,对CRI值、平卧位时的SV、TPR及立位时的BP没有影响。(2)2种模式的反复体位改变试期间,多项心血管参数变化明显,并呈现出规律性的变化。(3)在第4~8次体位改变期间,HDT/HUT模式HR的变化值显著大于SUP/HUT模式的△HR。除前两次体位改变之外,HDT/HUT模式的△BP小于SUP/HUT模式的△BP。除了第8次体位改变之外,在每个体位的20s,HDT/HUT模式的△SV、△CO都小于SUP/HUT模式的△SV、△CO。(4)将第1次体位改变与第10次体位改变时的各项指标比较发现,HDT/HUT模式中,最后1次-15°60s时的SBP、MBP与第1次相比下降(P0.05),DBP有升高趋势;第10次+50°20s时SBP、MBP与第1次相比下降(P0.05),DBP有升高趋势;第10次+50°60s时SBP低于第1次时,DBP、MBP升高,但不具显著性;第10次体位改变时TPR高于第1次,但不具显著性。SUP/HUT模式中,除SBP在第10次0°60s时与第1次相比有下降趋势外,SBP、DBP、MBP在其他时间点都升高,并且在正角度时有显著性;第10次改变时TPR显著高于第1次。结论(1)2种模式的反复体位改变试验对心血管指标造成的影响具有一定的差异;(2)与HDT/HUT模式的反复体位试验相比,机体能够更好地适应SUP/HUT模式的反复体位改变试验对心血管造成的影响;(3)自主神经系统与外周血管因素共同参与反复体位改变试验期间的心血管调节变化,外周血管因素可能是引起两模式产生不同心血管效应的主要原因。
[Abstract]:Objective to compare the changes of multiple physiological indexes before, after and in the same group of subjects by repeated body position change stimulation of two different models in the same group of subjects. To elucidate the difference of cardiovascular effects of two repeated posture changes and their application directions. Methods 12 healthy men were tested with different models of repeated postural changes, and before the trial, The cardiovascular response of the subjects was measured at 75 掳for 5 min after 5 min. The parameters of supine position were used as control. The heart rate (HR), blood pressure (SBP), DBP (MBP), cardiac output (HUT) and total peripheral resistance (TPR) of the subjects at 2060 s in each position were analyzed. The results showed that the test of HDT / HUT model could enable the subjects to have a cardiovascular response index during the subsequent HUT examination. In supine position, SVCO in supine position was significantly lower than that before the test. The HUT1min level was significantly lower than that before the test. The SV increased significantly in the vertical position. The HUT / HUT model showed a decreasing trend. The HRCO in the supine position was decreased in the later HUT examination, and the level of HUT in the supine position was significantly decreased after the HUT examination in the supine position after the HUT examination, and the results showed that there was a significant decrease in the HUT level in the supine position after the HUT examination, and there was no significant difference between the two groups. There were no significant changes in multiple cardiovascular parameters during repeated postural changes in the two models, including CRI, supine position, and BP in orthostatic position, and no significant difference was found in the changes of cardiovascular parameters during the repeated postural changes of the two models, and there was no significant difference in the changes of cardiovascular parameters between the two models. The HR of HDT / HUT model was significantly higher than that of SUP/HUT model during the 4th postural change. The BP of HDT / HUT model was lower than that of SUP/HUT model except for the first two postural changes. In each position, SVCO in HDT / HUT mode was lower than that in SUP/HUT mode, CO. 4) the indexes of the first position change and the 10th position change were compared with each other in HDT / HUT mode. At the last one to 15 掳60s, the SBP of the SBP at the first time was higher than that of the first, and that at the 10th time at 50 掳20s was higher than that at the first time, and the SBP at the 10th time at 50 掳60s was lower than that at the first time, but there was no significant difference. TPR was higher at the 10th time than at the first time, but it was not significant in the model of .SUP / HUT, except for the decreasing trend of SBP at the 10th time (0 掳60s) compared with the first time (P < 0.01), and there was a significant increase in the SBP at the other time points, and there was a significant difference at the positive angle. The TPR at the 10th change was significantly higher than that at the first. Conclusion there is a certain difference in the effect of the repeated posture change test between the two models on cardiovascular indexes. (2) compared with the repeated posture test of the HDT/HUT model, there is a significant difference between the two models. The body can better adapt to the effect of repeated body position change test of SUP/HUT model on cardiovascular system) the autonomic nervous system and peripheral vascular factors are involved in the cardiovascular regulation during repeated posture change test. Peripheral vascular factors may be the main causes of different cardiovascular effects between the two models.
【作者单位】：北京体育大学运动人体科学学院;中国航天员科研训练中心;
【基金】：国家自然科学基金课题(81372126)
【分类号】：R85

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