Sun Xi-Qing, Yao Yong-Jie, Wu Xing-Yu, Jiang Shi-Zhong, Jiang Chang-Lin, Cao Xin-Sheng, Hao Wei-Ya, Qiao Zong-Lin
Department of Aerospace Biodynamics, Faculty of Aerospace Medicine, Fourth Military Medical University, Xi'an, PR China.
Aviat Space Environ Med. 2002 Apr;73(4):335-40.
Exposure to actual or simulated weightlessness is known to induce orthostatic intolerance in humans. Many different methods have been suggested to counteract orthostatic hypotension. The repetitive or prolonged application of lower body negative pressure (LBNP) has shown beneficial effects to counter orthostatic intolerance, but devoting so much time to countermeasures is not compatible with space mission objectives or costs. The purpose of the present study was to assess the effects of brief LBNP sessions against orthostatic intolerance during a 21-d head-down tilt (HDT) bed rest.
There were 12 healthy male volunteers who were exposed to -6 degrees HDT bed rest for 21 d. Six subjects received -30 mm Hg LBNP sessions for 1 h x d(-1) from day 15 to day 21 of the HDT, and six others served as control. Orthostatic tolerance was assessed by means of standard tilt test.
Before HDT, all the subjects in the two groups completed the tilt tests. After 21 d of HDT, five subjects of the control group and one subject of the LBNP group could not complete the tilt test due to presyncopal or syncopal symptoms. The mean upright time in the control group 13.0 +/- 4.0 min) was significantly shorter (p < 0.05) than that in the LBNP group (19.0 +/- 2.2 min). Body weight decreased significantly in the control group during HDT, while increasing significantly on day 21 of HDT in the LBNP group. Urine volume increased on days 15-21 of HDT in the control group, but remained unchanged throughout HDT in the LBNP group. A significant decrease in cardiac output and cardiac index, and a significant increase in total peripheral resistance, pre-ejection period, plasma renin activity, aldosterone, and prostaglandin 12 were observed during HDT in both groups. There were no significant differences in these parameters between the two groups.
Brief daily LBNP sessions were effective in preventing orthostatic intolerance induced by 21 d HDT bed rest. However, it did not improve cardiac pump and systolic functions and did not preserve volume regulating hormones.
已知暴露于实际或模拟失重环境会导致人体出现体位性不耐受。人们提出了许多不同的方法来对抗体位性低血压。重复或长时间应用下体负压(LBNP)已显示出对抗体位性不耐受的有益效果,但投入如此多时间进行对策与太空任务目标或成本不相符。本研究的目的是评估在21天头低位倾斜(HDT)卧床休息期间短暂的LBNP治疗对体位性不耐受的影响。
12名健康男性志愿者接受-6度HDT卧床休息21天。6名受试者在HDT的第15天至第21天接受-30mmHg的LBNP治疗,每天1小时,另外6名作为对照。通过标准倾斜试验评估体位耐受性。
HDT前,两组所有受试者均完成倾斜试验。HDT 21天后,对照组5名受试者和LBNP组1名受试者因晕厥前或晕厥症状无法完成倾斜试验。对照组的平均直立时间(13.0±4.0分钟)明显短于LBNP组(19.0±2.2分钟)(p<0.05)。HDT期间对照组体重显著下降,而LBNP组在HDT第21天体重显著增加。对照组在HDT第15 - 21天尿量增加,而LBNP组在整个HDT期间尿量保持不变。两组在HDT期间均观察到心输出量和心脏指数显著下降,总外周阻力、射血前期、血浆肾素活性、醛固酮和前列腺素12显著增加。两组在这些参数上无显著差异。
每天进行短暂的LBNP治疗可有效预防21天HDT卧床休息引起的体位性不耐受。然而,它并未改善心脏泵血和收缩功能,也未维持容量调节激素水平。