Villar Rodrigo, Hughson Richard L
Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada.
Clin Physiol Funct Imaging. 2013 May;33(3):186-91. doi: 10.1111/cpf.12008. Epub 2012 Nov 8.
This study hypothesized that central and local reflex mechanisms affecting vascular conductance (VC) through the popliteal artery compensated for the reduction in muscle perfusion pressure (MPP) to maintain popliteal blood flow (PBF) during head-down tilt (35˚ HDT), but not in head-up tilt (45˚ HUT). Resting measurements were made on 15 healthy men in prone position to facilitate the access to the popliteal artery, on two separate days in random order during horizontal (HOR), HDT or HUT. In each body position, the body was supported, and the ankles were maintained in relaxed state so that there was no muscle tension, as with normal standing. Popliteal blood flow velocity and popliteal arterial diameter were measured by ultrasound, and PBF was calculated. MPP was corrected to mid-calf from measured finger cuff pressure, and VC was estimated by dividing PBF by MPP. The MPP in HDT (48 ± 2 mmHg) was ~100mmHg less than in HUT (145 ± 2 mmHg). PBF was similar between HOR (51 ± 18 ml( ) min(-1) ) and HDT (47 ± 13 ml min(-1) ), but was lower in HUT (30 ± 9 ml min(-1) ). VC was different between HDT (1·0 ± 0·3 ml min(-1) mmHg(-1) ), HOR (0·6 ± 0·2 ml min(-1) mmHg(-1) ) and HUT (0·2 ± 0·1 ml min(-1) mmHg(-1) ). In conclusion, the interactions of central and local regulatory mechanisms resulted in a disproportionate reduction of VC during HUT lowering PBF even though MPP was higher, while in HDT, increased VC contributed to maintain PBF at the same level as the HOR control condition.
本研究假设,在头低位倾斜(35˚HDT)期间,通过腘动脉影响血管传导性(VC)的中枢和局部反射机制可补偿肌肉灌注压(MPP)的降低,以维持腘血流量(PBF),但在头高位倾斜(45˚HUT)时则不然。对15名健康男性在俯卧位进行静息测量,以便于在水平位(HOR)、HDT或HUT期间,于两个不同日期按随机顺序测量腘动脉。在每个体位,身体得到支撑,脚踝保持放松状态,以确保没有肌肉张力,如同正常站立时一样。通过超声测量腘血流速度和腘动脉直径,并计算PBF。根据测量的指套压力将MPP校正至小腿中部,并通过PBF除以MPP来估算VC。HDT时的MPP(48±2 mmHg)比HUT时(145±2 mmHg)低约100 mmHg。HOR(51±18 ml·min⁻¹)和HDT(47±13 ml·min⁻¹)时的PBF相似,但HUT时较低(30±9 ml·min⁻¹)。HDT(1.0±0.3 ml·min⁻¹·mmHg⁻¹)、HOR(0.6±0.2 ml·min⁻¹·mmHg⁻¹)和HUT(0.2±0.1 ml·min⁻¹·mmHg⁻¹)时的VC不同。总之,中枢和局部调节机制的相互作用导致HUT期间VC不成比例地降低,从而降低了PBF,尽管MPP较高;而在HDT时,VC增加有助于将PBF维持在与HOR对照条件相同的水平。