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青年和老年男性在中枢性低血容量应激期间压力反射对心率的控制

Baroreflex control of the heart rate during central hypovolemic stress in young and elderly men.

作者信息

Yamazaki Fumio, Tsutsui Yuka, Endo Yutaka, Sagawa Sueko, Shiraki Keizo

机构信息

Department of Clinical Pathophysiology, School of Health Sciences, University of Occupational and Environmental Health, Yahatanishi-ku, Kitakyushu 807-8555, Japan.

出版信息

J UOEH. 2004 Jun 1;26(2):179-92. doi: 10.7888/juoeh.26.179.

Abstract

To test the hypothesis that tolerance to central hypovolemic stress is diminished with a reduced sensitivity of cardiac baroreflex in young and old men, twenty-four healthy elderly male subjects (67.5+/-0.9 yrs) and 24 young male subjects (22.4+/-0.4 yrs) underwent a 21 min bout of ramped lower body negative pressure (LBNP) (0 to -60 mmHg, 10 mmHg each for 3 min). Heart rate(HR), blood pressure, thoracic impedance (Z0) and calf circumference were measured throughout the experimental period. The sensitivity (BRS) of arterial baroreflex control of the cardiac interval was calculated from spontaneous changes in beat-to-beat arterial pressure and the RR interval during the LBNP test. The occurrence of presyncope episodes during LBNP was 16.7% in elderly subjects and 37.5% in young subjects. The changes of HR, blood pressure, Z0 and calf circumference in the young (Young fainter group) and the elderly (Elderly fainter group) subjects who showed presyncope during LBNP did not differ from those in the subjects (Young and Elderly nonfainter groups) who did not show presyncope. The steady-state HR responses to the changes of Z0 during LBNP did not differ among the four groups. In young and elderly subjects, the baseline values of BRS in the fainter groups tended to be smaller than those in the nonfainter groups, and the difference in the young group was significant (P<0.05). No LBNP-related change of BRS was observed in elderly subjects, whereas a gradual LBNP-related decrease was observed in young subjects. These findings suggest that 1) aging does not increase intolerance to central hypovolemic stress induced by a given LBNP, 2) the reduced vagal BRS is related partly to low LBNP tolerance in young and elderly men.

摘要

为验证下述假设

在年轻男性和老年男性中,心脏压力反射敏感性降低会导致对中枢性低血容量应激的耐受性下降,24名健康老年男性受试者(67.5±0.9岁)和24名年轻男性受试者(22.4±0.4岁)接受了21分钟的阶梯式下体负压(LBNP)试验(从0至-60 mmHg,每3分钟增加10 mmHg)。在整个实验期间测量心率(HR)、血压、胸阻抗(Z0)和小腿周长。根据LBNP试验期间逐搏动脉压和RR间期的自发变化,计算心脏间期的动脉压力反射控制敏感性(BRS)。老年受试者在LBNP期间发生先兆晕厥的比例为16.7%,年轻受试者为37.5%。在LBNP期间出现先兆晕厥的年轻受试者(年轻晕厥组)和老年受试者(老年晕厥组),其HR、血压、Z0和小腿周长的变化与未出现先兆晕厥的受试者(年轻和老年未晕厥组)没有差异。四组在LBNP期间对Z0变化的稳态HR反应没有差异。在年轻和老年受试者中,晕厥组的BRS基线值往往低于未晕厥组,且年轻组的差异具有统计学意义(P<0.05)。老年受试者未观察到与LBNP相关的BRS变化,而年轻受试者则观察到与LBNP相关的逐渐下降。这些发现表明:1)衰老不会增加对给定LBNP诱导的中枢性低血容量应激的不耐受性;2)迷走神经BRS降低部分与年轻和老年男性的低LBNP耐受性有关。

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