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年轻男性和老年男性对分级下体负压的心血管反应。

Cardiovascular response to graded lower body negative pressure in young and elderly man.

作者信息

van Hoeyweghen R, Hanson J, Stewart M J, Dethune L, Davies I, Little R A, Horan M A, Kirkman E

机构信息

Department of Geriatric Medicine, University of Manchester, Manchester, UK.

出版信息

Exp Physiol. 2001 May;86(3):427-35. doi: 10.1113/eph8602153.

Abstract

Lower body negative pressure (LBNP) reduces central venous pressure (CVP) and cardiac output. The elderly are reported to have a limited capacity to increase cardiac output by increasing heart rate (HR), are especially dependent on end diastolic volume to maintain stroke volume and therefore should be especially vulnerable to LBNP. The present study compared the effects of LBNP in the young and old. Stroke volume was assessed non-invasively as stroke distance (SD) by aortovelography. Two groups of healthy male volunteers were studied: eight young (29.7 +/- 2.0 years, mean +/- S.E.M.) and nine old (70.1 +/- 0.9 years). LBNP was applied progressively at 17.5, 35 and 50 mmHg in 20 min steps, with measurements taken during each steady state. There were similar, significant, falls in CVP in both groups. SD fell significantly in both groups from respective control values of 24.8 +/- 1.6 and 16.6 +/- 0.9 cm to 12.5 +/- 1.3 and 8.9 +/- 0.4 cm at a LBNP of 50 mmHg. Although SD in the elderly was significantly lower than in the young, the LBNP-induced changes were not different between groups. Both groups produced similar significant increases in vascular resistance, HR, plasma vasopressin (AVP) and noradrenaline. Mean arterial blood pressure (MBP) and plasma adrenaline did not change significantly. Therefore healthy old men respond to LBNP in a similar manner to the young, although MBP and SD are regulated around different baselines in the two groups.

摘要

下体负压(LBNP)可降低中心静脉压(CVP)和心输出量。据报道,老年人通过增加心率(HR)来增加心输出量的能力有限,尤其依赖舒张末期容积来维持每搏输出量,因此应该特别容易受到LBNP的影响。本研究比较了LBNP对年轻人和老年人的影响。通过主动脉血管造影术将每搏输出量作为搏出距离(SD)进行无创评估。研究了两组健康男性志愿者:八名年轻人(29.7±2.0岁,平均值±标准误)和九名老年人(70.1±0.9岁)。以20分钟为步长,逐步施加17.5、35和50 mmHg的LBNP,并在每个稳定状态下进行测量。两组的CVP均出现相似且显著的下降。在50 mmHg的LBNP下,两组的SD均从各自的对照值24.8±1.6和16.6±0.9 cm显著下降至12.5±1.3和8.9±0.4 cm。尽管老年人的SD显著低于年轻人,但LBNP引起的变化在两组之间并无差异。两组的血管阻力、HR、血浆血管加压素(AVP)和去甲肾上腺素均出现相似且显著的增加。平均动脉血压(MBP)和血浆肾上腺素无显著变化。因此,健康老年男性对LBNP的反应与年轻人相似,尽管两组的MBP和SD围绕不同的基线进行调节。

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