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代谢反射对代谢综合征患者心血管系统的影响。

Effect of Metaboreflex on Cardiovascular System in Subjects of Metabolic Syndrome.

作者信息

Dubey Pramita, Tiwari Sunita, Bajpai Manish, Singh Kalpana, Jha Praveen

机构信息

Junior Resident, Department of Physiology, KGMU, Lucknow, Uttar Pradesh, India.

Professor and Head, Department of Physiology, KGMU, Lucknow, Uttar Pradesh, India.

出版信息

J Clin Diagn Res. 2017 Jul;11(7):CC01-CC04. doi: 10.7860/JCDR/2017/27583.10178. Epub 2017 Jul 1.

Abstract

INTRODUCTION

Metaboreflex is a reflex in which muscle receptors send signals regarding metabolic (metabolites accumulation like lactic acid, potassium, adenosine) conditions of the muscles to nucleus tractus solitarius via afferent III and IV fibres to cause haemodynamic adjustments in order to regulate blood flow on the basis of the status of contracting muscle. Dysregulation in its mechanism in metabolic syndrome is demonstrated.

AIM

To study the effect of metaboreflex by both isometric and rhythmic handgrip exercise on CVS parameters {Blood Pressure (BP), Cardiac Output (CO) and Systemic Vascular Resistance (SVR)} in subjects of metabolic syndrome.

MATERIALS AND METHODS

In this study, 27 subjects aged 25 to 45 years were enrolled after ethical clearance and proper consent. They were divided into: a) subjects without metabolic syndrome; and b) subjects with metabolic syndrome. Impedance cardiovasography was done to assess cardiac parameters (systolic and diastolic blood pressure, cardiac output, systemic vascular resistance). Pre-exercise parameters were assessed followed by isometric exercise and post-isometric exercise parameter measurement. Again after rest, rhythmic exercise was followed. Finally post exercise parameters were assessed. Student paired t-test for comparison between pre and post exercise parameters were done.

RESULTS

Changes in diastolic BP following exercise were statistically significant in subjects without metabolic syndrome (p-value 0.01 and 0.001 following isometric and rhythmic exercise respectively). In subjects with metabolic syndrome also these changes were significant, but to a lesser extent (p-value 0.1 and 0.01 respectively for isometric and rhythmic exercise). Changes in systolic BP following exercise were statistically significant in subjects without metabolic syndrome (p-value 0.001 and 0.001 following isometric and rhythmic exercise respectively). In subjects with metabolic syndrome also these changes were significant (p-value 0.01 and 0.001 respectively for isometric and rhythmic exercise).

CONCLUSION

Diminished pressor response is found after exercise in subjects with metabolic syndrome.

摘要

引言

代谢反射是一种反射,在该反射中,肌肉感受器通过传入的Ⅲ和Ⅳ纤维将有关肌肉代谢状况(如乳酸、钾、腺苷等代谢产物积累)的信号发送至孤束核,以引起血流动力学调整,从而根据收缩肌肉的状态调节血流。已证实其在代谢综合征中的机制失调。

目的

研究等长和节律性握力运动引起的代谢反射对代谢综合征患者心血管系统参数{血压(BP)、心输出量(CO)和全身血管阻力(SVR)}的影响。

材料与方法

本研究经伦理审查并获得适当同意后,招募了27名年龄在25至45岁之间的受试者。他们被分为:a)无代谢综合征的受试者;b)有代谢综合征的受试者。采用阻抗心动描记法评估心脏参数(收缩压和舒张压、心输出量、全身血管阻力)。在进行等长运动前评估参数,之后测量等长运动后的参数。休息后,再进行节律性运动。最后评估运动后的参数。采用学生配对t检验比较运动前后的参数。

结果

在无代谢综合征的受试者中,运动后舒张压的变化具有统计学意义(等长运动和节律性运动后p值分别为0.01和0.001)。在有代谢综合征的受试者中,这些变化也具有统计学意义,但程度较小(等长运动和节律性运动后p值分别为0.1和0.01)。在无代谢综合征的受试者中,运动后收缩压的变化具有统计学意义(等长运动和节律性运动后p值分别为0.001和0.001)。在有代谢综合征的受试者中,这些变化也具有统计学意义(等长运动和节律性运动后p值分别为0.01和0.001)。

结论

发现代谢综合征患者运动后升压反应减弱。

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