Arbeille Philippe P, Besnard Stephane S, Kerbeci Pascaline P, Mohty Dania M
Unité Médecine et Physiologie Spatiale, Departement de Médecine Nucléaire et Ultrasons, Centres Hospitaliers Universitaires Trousseau, 37044 Tours, France.
J Appl Physiol (1985). 2005 Nov;99(5):1853-7. doi: 10.1152/japplphysiol.00331.2005.
The objective of this study was to evaluate the changes in the portal vein cross-sectional area (PV CSA) and flow during a stand test associated with orthostatic intolerance. Eighteen subjects underwent a 90-day head-down tilt (HDT) bed rest at 6 degrees: 9 controls (Con) and 9 with flywheel exercise countermeasures (CM). At post-HDT, nine subjects (5 CM, 4 Con) were tolerant, and nine were intolerant. The PV CSA was measured by echography. We found that at HDT day 85, the PV CSA at rest had increased less in the CM subjects than in the Con (+12 vs. +27% from pre-HDT supine; P < 0.05), whereas it increased similarly in tolerant and intolerant subjects (23 and 16%, respectively). Two days after the HDT, there was a decrease in the PV CSA supine compared with the pre-HDT PV CSA supine that was similar for all groups (Con: -11%, CM: -21%; tolerant: -10%, intolerant: -16%; P < 0.05). The PV CSA decreased significantly less from supine to standing in the Con than in the CM group (-2 vs. -10% compared with the pre-HDT stand test; P < 0.05). The PV CSA also decreased significantly from supine to standing compared with the pre-HDT stand test in the tolerant group but not in the intolerant group (-20 vs. +2%; P < 0.05). From these findings, we conclude the following. 1) Because the portal vein is the only output from the splanchnic vascular area, we suggest that the lower reduction in the PV CSA and flow associated with orthostatic intolerance was related to a lower splanchnic arterial vasoconstriction. 2) The flywheel exercise CM helped to reduce the distention of the splanchnic network at rest and to maintain partially the splanchnic vasoconstriction, but it did not reduce the orthostatic intolerance.
本研究的目的是评估与直立不耐受相关的站立试验期间门静脉横截面积(PV CSA)和血流的变化。18名受试者在6度头低位倾斜(HDT)床上休息90天:9名对照组(Con)和9名采用飞轮运动对策(CM)。HDT后,9名受试者(5名CM,4名Con)耐受,9名不耐受。通过超声检查测量PV CSA。我们发现,在HDT第85天,CM组受试者静息时PV CSA的增加量低于Con组(与HDT前仰卧位相比,分别为+12%和+27%;P<0.05),而耐受和不耐受受试者的增加量相似(分别为23%和16%)。HDT后两天,与HDT前仰卧位的PV CSA相比,所有组仰卧位的PV CSA均下降,且相似(Con组:-11%,CM组:-21%;耐受组:-10%,不耐受组:-16%;P<0.05)。Con组从仰卧位到站立位PV CSA的下降幅度明显小于CM组(与HDT前站立试验相比,分别为-2%和-10%;P<0.05)。与HDT前站立试验相比,耐受组从仰卧位到站立位PV CSA也显著下降,而不耐受组则未下降(分别为-20%和+2%;P<0.05)。基于这些发现,我们得出以下结论。1) 由于门静脉是内脏血管区域的唯一输出,我们认为与直立不耐受相关的PV CSA和血流的较低减少与较低的内脏动脉血管收缩有关。2) 飞轮运动对策有助于减少静息时内脏网络的扩张,并部分维持内脏血管收缩,但并未降低直立不耐受。