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肢体运动诱发的充血具有中枢血流动力学成分:来自神经阻滞研究的证据。

Limb movement-induced hyperemia has a central hemodynamic component: evidence from a neural blockade study.

机构信息

Geriatric Research, Education, and Clinical Center, George E. Whalen Veterans Affairs Medical Center, Salt Lake City, Utah, USA.

出版信息

Am J Physiol Heart Circ Physiol. 2010 Nov;299(5):H1693-700. doi: 10.1152/ajpheart.00482.2010. Epub 2010 Aug 27.

Abstract

The purpose of this investigation was to partially remove feedback from type III/IV skeletal muscle afferents and determine how this feedback influences the central and peripheral hemodynamic responses to passive leg movement. Heart rate (HR), stroke volume (SV), cardiac output (CO), mean arterial pressure, leg vascular conductance (LVC), and leg blood flow (LBF) were measured during 2 min of passive knee extension in eight young men before and after intrathecal fentanyl injection. Passive movement increased HR by 14 beats/min from baseline to maximal response during control (CON) (65 ± 4 to 79 ± 5 beats/min, P < 0.05), whereas HR did not significantly increase with the fentanyl block (BLK). LBF and LVC increased in both conditions; however, these increases were attenuated and delayed during BLK [%change from baseline to maximum, LBF: CON 295 ± 109 vs. BLK 210 ± 86%, (P < 0.05); LVC: CON 322 ± 40% vs. BLK 231 ± 32%, (P < 0.04)]. In CON, HR, SV, CO, and LVC increased contributing to the hyperemic response. However, under BLK conditions, statistically insignificant increases in HR and SV combined to yield a small, but significant, increase in CO and an attenuated hyperemic response. Therefore, partially blocking skeletal muscle afferent feedback blunts the central hemodynamic response due to passive limb movement, which then results in an attenuated and delayed movement-induced hyperemia. In combination, these findings provide evidence that limb movement-induced hyperemia has a significant central hemodynamic component induced by peripheral nerve activation.

摘要

本研究旨在部分去除 III/IV 型骨骼肌传入神经的反馈,并确定这种反馈如何影响被动腿部运动引起的中枢和外周血液动力学反应。在 8 名年轻男性中,在鞘内注射芬太尼前后,分别在 2 分钟的被动膝关节伸展过程中测量心率(HR)、每搏量(SV)、心输出量(CO)、平均动脉压、腿部血管传导性(LVC)和腿部血流(LBF)。在对照(CON)条件下,被动运动使 HR 从基线增加 14 次/分钟至最大反应(65 ± 4 至 79 ± 5 次/分钟,P < 0.05),而芬太尼阻滞(BLK)时 HR 没有显著增加。在两种情况下,LBF 和 LVC 均增加;然而,在 BLK 期间,这些增加被减弱和延迟 [从基线到最大的百分比变化,LBF:CON 295 ± 109 对 BLK 210 ± 86%,(P < 0.05);LVC:CON 322 ± 40%对 BLK 231 ± 32%,(P < 0.04)]。在 CON 条件下,HR、SV、CO 和 LVC 的增加导致了充血反应。然而,在 BLK 条件下,HR 和 SV 的统计上无显著性增加,导致 CO 的微小但显著增加和充血反应的减弱。因此,部分阻断骨骼肌传入神经反馈会减弱因被动肢体运动引起的中枢血液动力学反应,从而导致运动诱导的充血反应减弱和延迟。综上所述,这些发现提供了证据,表明肢体运动诱导的充血具有由周围神经激活引起的显著中枢血液动力学成分。

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