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头低位卧床休息会损害迷走神经压力反射反应并引发体位性低血压。

Head-down bed rest impairs vagal baroreflex responses and provokes orthostatic hypotension.

作者信息

Convertino V A, Doerr D F, Eckberg D L, Fritsch J M, Vernikos-Danellis J

机构信息

National Aeronautics and Space Administration, Space Center, Florida 32899.

出版信息

J Appl Physiol (1985). 1990 Apr;68(4):1458-64. doi: 10.1152/jappl.1990.68.4.1458.

Abstract

We studied vagally mediated carotid baroreceptor-cardiac reflexes in 11 healthy men before, during, and after 30 days of 6 degrees head-down bed rest to test the hypothesis that baroreflex malfunction contributes to orthostatic hypotension in this model of simulated microgravity. Sigmoidal baroreflex response relationships were provoked with ramped neck pressure-suction sequences comprising pressure elevations to 40 mmHg followed by serial R-wave-triggered 15-mmHg reductions to -65 mmHg. Each R-R interval was plotted as a function of systolic pressure minus the neck chamber pressure applied during the interval. Compared with control measurements, base-line R-R intervals and the minimum, maximum, range, and maximum slope of the R-R interval-carotid pressure relationships were reduced (P less than 0.05) from bed rest day 12 through recovery day 5. Baroreflex slopes were reduced more in four subjects who fainted during standing after bed rest than in six subjects who did not faint (-1.8 +/- 0.7 vs. -0.3 +/- 0.3 ms/mmHg, P less than 0.05). There was a significant linear correlation (r = 0.70, P less than 0.05) between changes of baroreflex slopes from before bed rest to bed rest day 25 and changes of systolic blood pressure during standing after bed rest. Although plasma volume declined by approximately 15% (P less than 0.05), there was no significant correlation between reductions of plasma volume and changes of baroreflex responses. There were no significant changes of before and after plasma norepinephrine or epinephrine levels before and after bed rest during supine rest or sitting.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

我们研究了11名健康男性在6度头低位卧床休息30天之前、期间和之后由迷走神经介导的颈动脉压力感受器-心脏反射,以检验压力感受器反射功能障碍导致这种模拟微重力模型中体位性低血压的假说。通过斜坡式颈部压力-吸引序列激发S形压力感受器反射反应关系,该序列包括将压力升高至40 mmHg,随后以R波触发依次将压力降低15 mmHg直至-65 mmHg。将每个R-R间期绘制为收缩压减去该间期施加的颈部腔室压力的函数。与对照测量相比,从卧床休息第12天至恢复第5天,基线R-R间期以及R-R间期-颈动脉压力关系的最小值、最大值、范围和最大斜率均降低(P<0.05)。在卧床休息后站立时晕倒的4名受试者中,压力感受器反射斜率的降低幅度大于未晕倒的6名受试者(-1.8±0.7 vs. -0.3±0.3 ms/mmHg,P<0.05)。从卧床休息前至卧床休息第25天压力感受器反射斜率的变化与卧床休息后站立时收缩压的变化之间存在显著线性相关(r = 0.70,P<0.05)。尽管血浆量下降了约15%(P<0.05),但血浆量的减少与压力感受器反射反应的变化之间无显著相关性。在仰卧休息或坐位时,卧床休息前后血浆去甲肾上腺素或肾上腺素水平无显著变化。(摘要截短于250字)

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