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潜水反射:心率降低的时程可否量化?

Diving reflex: can the time course of heart rate reduction be quantified?

机构信息

Research Group Experimental Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.

出版信息

Scand J Med Sci Sports. 2011 Feb;21(1):18-31. doi: 10.1111/j.1600-0838.2010.01246.x. Epub 2010 Nov 18.

Abstract

In this meta-analysis of diving bradycardia in humans, we sought to quantify any heart rate (HR) reduction using a relatively simple mathematical function. Using the terms "diving reflex,""diving bradycardia,""diving response,""diving plus heart rate," databases were searched. Data from the studies were fitted using HR=c+aexp(-(t-t(0))/τ), where c is the final HR, a is the HR decrease, τ is the time constant of HR decay, and t(0) is the time delay. Of 890 studies, 220 were given closer scrutiny. Only eight of these provided data obtained under comparable conditions. Apneic facial immersion decreased HR with τ=10.4 s and in air alone it was less pronounced and slower (τ=16.2 s). The exponential function fitted the time course of HR decrease closely (r(2)>0.93). The fit was less adequate for apneic-exercising volunteers. During apnea both with and without face immersion, HR decreases along a monoexponential function with a characteristic time constant. HR decrease during exercise with and without face immersion could not readily be described with a simple function: the parasympathetic reaction was partially offset by some sympathetic activity. Thus, we succeeded in quantifying the early time course of diving bradycardia. It is concluded that the diving reflex is useful to diagnose the integrity of efferent cardiovascular autonomic pathways.

摘要

在这项对人类潜水性心动过缓的荟萃分析中,我们试图使用相对简单的数学函数来量化任何心率(HR)的降低。使用术语“潜水反射”、“潜水性心动过缓”、“潜水反应”、“潜水加心率”,搜索数据库。使用 HR=c+aexp(-(t-t(0))/τ) 拟合研究数据,其中 c 是最终 HR,a 是 HR 降低值,τ 是 HR 衰减的时间常数,t(0)是时间延迟。在 890 项研究中,有 220 项进行了更仔细的检查。只有其中的 8 项提供了在可比条件下获得的数据。在无氧条件下进行面部浸入会降低心率,τ=10.4 s,而在空气中则不那么明显且较慢(τ=16.2 s)。指数函数非常适合 HR 降低的时间过程(r(2)>0.93)。对于进行无氧运动的志愿者,拟合效果较差。在有或没有面部浸入的情况下进行的无氧运动中,HR 按照单指数函数降低,具有特征时间常数。在有或没有面部浸入的情况下进行的运动中,HR 降低不能轻易用简单的函数来描述:部分交感神经活动抵消了副交感神经反应。因此,我们成功地量化了潜水性心动过缓的早期时间过程。结论是,潜水反射可用于诊断传出心血管自主神经通路的完整性。

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