Sharma Shalini, Gupta Rani, Nautiyal Anupama, Sindhwani Girish
Department of Physiology, PGIMS, Rohtak, Haryana.
Indian J Physiol Pharmacol. 2012 Jul-Sep;56(3):201-12.
In COPD, overactivation of ergoreceptors may be a link between peripheral changes, sympathetic over activation and increased hemodynamic and ventilatory responses to exercise. The current study was undertaken to test the hypothesis that, ergoreflex in COPD patients is hyperactive and contributes to breathlessness and exercise limitation. The aim of study was to (1) demonstrate its hyperactivity in COPD (2). To record other efferent effects. Twenty stable COPD male patients aged 50 +/- 2.5 years and twenty healthy male subjects aged 48 +/- 3.5 years were studied under experimental and control groups. The ergoreflex contribution to cardio respiratory parameters was assessed by post-handgrip regional circulatory occlusion method (PH-RCO) and computed as the difference in heart rate and respiratory rate response between PH-RCO and control run without PH-RCO. Results were analyzed for significance between two groups by repeated measures ANOVA. COPD patients showed over activation of ergoreflex as compared to control subjects in terms of heart rate during sustained hand grip (SHG) exercise (117 +/- 1.22 versus 89 +/- 0.89) beats/min, recovery heart rate (p < 0.001), and respiratory rate during SHG (24 +/- 0.54 versus 19 +/- 03.24) breaths/min and recovery respiratory rate (p < 0.001). Degree of overactivation of ergoreflex was significant in COPD patients (p < 0.001). In COPD, overactivity of ergoreflex is associated with abnormal cardio respiratory reflex control. COPD patients showed overactivation of sympathetic nervous system as evidenced by heart rate changes during exercise and delayed recovery.
在慢性阻塞性肺疾病(COPD)中,动静脉感受器过度激活可能是外周变化、交感神经过度激活以及运动时血流动力学和通气反应增加之间的一个联系。本研究旨在验证以下假设:COPD患者的动静脉反射亢进,并导致呼吸困难和运动受限。研究目的是:(1)证明其在COPD中的亢进;(2)记录其他传出效应。将20名年龄在50±2.5岁的稳定期COPD男性患者和20名年龄在48±3.5岁的健康男性受试者分为实验组和对照组进行研究。通过握力后局部循环阻断法(PH-RCO)评估动静脉反射对心肺参数的影响,并计算为PH-RCO与无PH-RCO的对照试验之间心率和呼吸频率反应的差异。采用重复测量方差分析对两组结果的显著性进行分析。与对照组相比,COPD患者在持续握力(SHG)运动期间的心率(117±1.22对89±0.89)次/分钟、恢复心率(p<0.001)、SHG期间的呼吸频率(24±0.54对19±03.24)次/分钟和恢复呼吸频率(p<0.001)方面表现出动静脉反射过度激活。COPD患者动静脉反射的过度激活程度具有显著性(p<0.001)。在COPD中,动静脉反射亢进与心肺反射控制异常有关。COPD患者表现出交感神经系统过度激活,运动期间心率变化及恢复延迟证明了这一点。