使用炎症反应对两种技术潜水减压程序进行比较评估：分区减压与比率减压。
A comparative evaluation of two decompression procedures for technical diving using inflammatory responses: compartmental versus ratio deco.
作者信息
Spisni Enzo, Marabotti Claudio, De Fazio Luigia, Valerii Maria Chiara, Cavazza Elena, Brambilla Stefano, Hoxha Klarida, L'Abbate Antonio, Longobardi Pasquale
机构信息
Department of Biological, Geological and Environmental Sciences, Translational Physiology and Nutrition Unit, University of Bologna, Via Selmi 3, 40126 Bologna, Italy,
Department of Biological, Geological and Environmental, Sciences, University of Bologna, Italy.
出版信息
Diving Hyperb Med. 2017 Mar;47(1):9-16. doi: 10.28920/dhm47.1.9-16.
INTRODUCTION
The aim of this study was to compare two decompression procedures commonly adopted by technical divers: the ZH-L16 algorithm modified by 30/85 gradient factors (compartmental decompression model, CDM) versus the 'ratio decompression strategy' (RDS). The comparison was based on an analysis of changes in diver circulating inflammatory profiles caused by decompression from a single dive.
METHODS
Fifty-one technical divers performed a single trimix dive to 50 metres' sea water (msw) for 25 minutes followed by enriched air (EAN50) and oxygen decompression. Twenty-three divers decompressed according to a CDM schedule and 28 divers decompressed according to a RDS schedule. Peripheral blood for detection of inflammatory markers was collected before and 90 min after diving. Venous gas emboli were measured 30 min after diving using 2D echocardiography. Matched groups of 23 recreational divers (dive to 30 msw; 25 min) and 25 swimmers were also enrolled as control groups to assess the effects of decompression from a standard air dive or of exercise alone on the inflammatory profile.
RESULTS
Echocardiography at the single 30 min observation post dive showed no significant differences between the two decompression procedures. Divers adopting the RDS showed a worsening of post-dive inflammatory profile compared to the CDM group, with significant increases in circulating chemokines CCL2 (P = 0.001) and CCL5 (P = 0.006) levels. There was no increase in chemokines following the CDM decompression. The air scuba group also showed a statistically significant increase in CCL2 (P < 0.001) and CCL5 (P = 0.003) levels post dive. No cases of decompression sickness occurred.
CONCLUSION
The ratio deco strategy did not confer any benefit in terms of bubbles but showed the disadvantage of increased decompression-associated secretion of inflammatory chemokines involved in the development of vascular damage.
引言
本研究的目的是比较技术潜水员常用的两种减压程序：通过30/85梯度因子修改的ZH-L16算法（房室减压模型，CDM）与“比率减压策略”（RDS）。该比较基于对单次潜水减压引起的潜水员循环炎症谱变化的分析。
方法
51名技术潜水员进行了一次到50米海水（msw）深度的单一氦氧混合气潜水，持续25分钟，随后进行富氧空气（EAN50）和氧气减压。23名潜水员按照CDM时间表减压，28名潜水员按照RDS时间表减压。在潜水前和潜水后90分钟采集外周血以检测炎症标志物。潜水后30分钟使用二维超声心动图测量静脉气体栓塞。还招募了23名休闲潜水员（潜水到30 msw；25分钟）和25名游泳者作为匹配组作为对照组，以评估标准空气潜水减压或单独运动对炎症谱的影响。
结果
潜水后单次30分钟观察时的超声心动图显示，两种减压程序之间无显著差异。与CDM组相比，采用RDS的潜水员潜水后的炎症谱恶化，循环趋化因子CCL2（P = 0.001）和CCL5（P = 0.006）水平显著升高。CDM减压后趋化因子没有增加。水肺空气潜水组潜水后CCL2（P < 0.001）和CCL5（P = 0.003）水平也有统计学显著升高。未发生减压病病例。
结论
比率减压策略在气泡方面没有带来任何益处，但显示出在减压相关的炎症趋化因子分泌增加方面的劣势，这些趋化因子参与血管损伤的发展。
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