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静脉气体栓子与潜水后的宏观而非微血管功能障碍有关。

Venous gas emboli are involved in post-dive macro, but not microvascular dysfunction.

作者信息

Lambrechts Kate, Balestra Costantino, Theron Michaël, Henckes Anne, Galinat Hubert, Mignant Fanny, Belhomme Marc, Pontier Jean-Michel, Guerrero François

机构信息

ORPHY Laboratory, UBO, 6 avenue Le Gorgeu, 29200, Brest, France.

IRBA-ERRSO, Armed Forces Biomedical Research Institute-Resident Operational Subaquatic Research Team, Toulon, BP 610, 83800, Toulon, France.

出版信息

Eur J Appl Physiol. 2017 Feb;117(2):335-344. doi: 10.1007/s00421-017-3537-9. Epub 2017 Jan 21.

Abstract

PURPOSE

Previous studies have shown vascular dysfunction of main conductance arteries and microvessels after diving. We aim to evaluate the impact of bubble formation on vascular function and haemostasis. To achieve this, we used a vibration preconditioning to influence bubble levels without changing any other parameters linked to the dive.

METHODS

Twentty-six divers were randomly assigned to one of three groups: (1) the "vibrations-dive" group (VD; n = 9) was exposed to a whole-body vibration session 30 min prior the dive; (2) the "diving" group (D; n = 9) served as a control for the effect of the diving protocol; (3) The "vibration" protocol (V; n = 8) allowed us to assess the effect of vibrations without diving. Macro- and microvascular function was assessed for each subject before and after the dive, subsequently. Bubble grades were monitored with Doppler according to the Spencer grading system. Blood was taken before and after the protocol to assess any change of platelets or endothelial function.

RESULTS

Bubble formation was lower in the VD than the diving group. The other measured parameters remained unchanged after the "vibration" protocol alone. Diving alone induced macrovascular dysfunction, and increased PMP and thrombin generation. Those parameters were no longer changed in the VD group. Conversely, a microvascular dysfunction persists despite a significant decrease of circulating bubbles.

CONCLUSIONS

Finally, the results of this study suggest that macro- but not microvascular impairment results at least partly from bubbles, possibly related to platelet activation and generation of pro-coagulant microparticles.

摘要

目的

先前的研究表明潜水后主要传导动脉和微血管存在血管功能障碍。我们旨在评估气泡形成对血管功能和止血的影响。为实现这一目标,我们采用振动预处理来影响气泡水平,同时不改变与潜水相关的任何其他参数。

方法

26名潜水员被随机分为三组之一:(1)“振动 - 潜水”组(VD;n = 9)在潜水前30分钟接受全身振动训练;(2)“潜水”组(D;n = 9)作为潜水方案效果的对照组;(3)“振动”方案组(V;n = 8)使我们能够评估无潜水情况下振动的效果。随后,在潜水前后对每位受试者的大血管和微血管功能进行评估。根据斯宾塞分级系统用多普勒监测气泡等级。在方案前后采集血液以评估血小板或内皮功能的任何变化。

结果

VD组的气泡形成低于潜水组。仅“振动”方案后,其他测量参数保持不变。单独潜水会导致大血管功能障碍,并增加血小板微粒(PMP)和凝血酶的生成。在VD组中,这些参数不再变化。相反,尽管循环气泡显著减少,但微血管功能障碍仍然存在。

结论

最后,本研究结果表明,大血管而非微血管损伤至少部分是由气泡引起的,可能与血小板活化和促凝血微粒的产生有关。

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