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人体骨骼肌交感神经活动、心率及肢体血流动力学与血氧降低和运动的关系

Human skeletal muscle sympathetic nerve activity, heart rate and limb haemodynamics with reduced blood oxygenation and exercise.

作者信息

Hanada Akiko, Sander Mikael, González-Alonso José

机构信息

Copenhagen Muscle Research Centre, Rigshospitalet, University of Copenhagen, Denmark.

出版信息

J Physiol. 2003 Sep 1;551(Pt 2):635-47. doi: 10.1113/jphysiol.2003.044024. Epub 2003 Aug 8.

Abstract

Acute systemic hypoxia causes significant increases in human skeletal muscle sympathetic nerve activity (MSNA), heart rate and ventilation. This phenomenon is thought to be primarily mediated by excitation of peripheral chemoreceptors sensing a fall in arterial free oxygen partial pressure (Pa,O2). We directly tested the role of Pa,O2 on MSNA (peroneal microneurography), heart rate, ventilation and leg haemodynamics (n = 7-8) at rest and during rhythmic handgrip exercise by using carbon monoxide (CO) to mimic the effect of systemic hypoxia on arterial oxyhaemoglobin (approximately 20 % lower O2Hba), while normalising or increasing Pa,O2 (range 40-620 mmHg). The four experimental conditions were: (1) normoxia (Pa,O2 approximately 110 mmHg; carboxyhaemoglobin (COHb) approximately 2 %); (2) hypoxia (Pa,O2 approximately 40 mmHg; COHb approximately 2 %); (3) CO + normoxia (Pa,O2 approximately 110 mmHg; COHb approximately 23 %); and (4) CO + hyperoxia (Pa,O2 approximately 620 mmHg; COHb ~24 %). Acute hypoxia augmented sympathetic burst frequency, integrated MSNA, heart rate and ventilation compared to normoxia over the entire protocol (7-13 bursts min-1, 100-118 %, 13-17 beats min-1, 2-4 l min-1, respectively, P < 0.05). The major new findings were: (1) CO + normoxia and CO + hyperoxia also elevated MSNA compared to normoxia (63-144 % increase in integrated MSNA; P < 0.05) but they did not increase heart rate (62-67 beats min-1) or ventilation (6.5-6.8 l min-1), and (2) despite the 4-fold elevation in MSNA with hypoxaemia and exercise, resting leg blood flow, vascular conductance and O2 uptake remained unchanged. In conclusion, the present results suggest that increases in MSNA with CO are not mediated by activation of the chemoreflex, whereas hypoxia-induced tachycardia and hyperventilation are mediated by activation of the chemoreflex in response to the decline in Pa,O2. Our findings also suggest that Pa,O2 is not an obligatory signal involved in the enhanced MSNA with reduced blood oxygenation.

摘要

急性全身性缺氧会导致人体骨骼肌交感神经活动(MSNA)、心率和通气量显著增加。这种现象被认为主要是由外周化学感受器兴奋介导的,这些感受器感知到动脉血游离氧分压(Pa,O2)下降。我们通过使用一氧化碳(CO)来模拟全身性缺氧对动脉氧合血红蛋白的影响(氧合血红蛋白降低约20%),同时使Pa,O2正常化或升高(范围为40 - 620 mmHg),直接测试了Pa,O2在静息和有节奏握力运动期间对MSNA(腓骨微神经图)、心率、通气量和腿部血流动力学(n = 7 - 8)的作用。四个实验条件分别为:(1)常氧(Pa,O2约为110 mmHg;碳氧血红蛋白(COHb)约为2%);(2)缺氧(Pa,O2约为40 mmHg;COHb约为2%);(3)CO + 常氧(Pa,O2约为110 mmHg;COHb约为23%);以及(4)CO + 高氧(Pa,O2约为620 mmHg;COHb约为24%)。与常氧相比,在整个实验过程中,急性缺氧增加了交感神经爆发频率、综合MSNA、心率和通气量(分别为7 - 13次/分钟、100 - 118%、13 - 17次/分钟、2 - 4升/分钟,P < 0.05)。主要的新发现是:(1)与常氧相比,CO + 常氧和CO + 高氧也提高了MSNA(综合MSNA增加63 - 144%;P < 0.05),但它们没有增加心率(62 - 67次/分钟)或通气量(6.5 - 6.8升/分钟),并且(2)尽管低氧血症和运动使MSNA升高了4倍,但静息时腿部血流量、血管传导率和氧摄取量保持不变。总之,目前的结果表明,CO引起的MSNA增加不是由化学反射激活介导的,而缺氧诱导的心动过速和过度通气是由对Pa,O2下降的化学反射激活介导的。我们的研究结果还表明,Pa,O2不是血液氧合降低时增强MSNA所涉及的必要信号。

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