面部浸入作为人体副交感神经活动测试方法的局限性。

Limitations of facial immersion as a test of parasympathetic activity in man.

作者信息

Gallo L, Maciel B C, Manço J C, Marin Neto J A

机构信息

Department of Internal Medicine, University Hospital School of Medicine of Ribeirão Preto, University of São Paulo, Brazil.

出版信息

J Physiol. 1988 Feb;396:1-10. doi: 10.1113/jphysiol.1988.sp016945.

DOI:10.1113/jphysiol.1988.sp016945

PMID:3411491

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1192028/

Abstract

The heart rate response to immersion of the face in water, as an isolated manoeuvre or in combination with apnoea, was studied in eight normal volunteers to establish the conditions under which it could be used as a standardized, simple, non-invasive and reproducible test of parasympathetic activity. 2. The following procedures were evaluated: (a) 10 s apnoea in air at different lung volumes; (b) facial immersion in water for 2 min at various temperatures (5, 15 and 25 degrees C), with respiration maintained through a closed circuit; (c) combination of immersion and apnoea at different lung volumes. Three volunteers were re-evaluated after pharmacological blockade with atropine sulphate (0.04 mg/kg body weight). 3. The results showed that: (a) apnoea in air triggered lung volume-dependent heart rate responses; (b) facial immersion in water induced transient bradycardia which was maximum between 20 and 30 s of immersion; (c) there was no appreciable difference in the bradycardia evoked by immersion at different temperatures; (d) the combination of immersion and apnoea caused heterogeneous heart rate responses with no potentiation of bradycardia in relation to each manoeuvre as performed separately; (e) atropine did not reduce the magnitude of bradycardia induced by immersion in two of the subjects studied. 4. The variability of responses observed in the present study was probably due to the multiple receptors and afferent pathways that are simultaneously excited during these manoeuvres. As a consequence, the autonomic efferent response will depend on the unpredictable net effect of interaction of these mechanisms. This is a limiting factor for the standardization of this test as a simple and reproducible method for the assessment of parasympathetic activity. 5. Furthermore, the results obtained under pharmacological blockade indicate that the vagal efferent mechanism is not the only factor responsible for the bradycardia caused by facial immersion without apnoea.

摘要

对8名正常志愿者进行了研究，观察面部浸入水中这一单独操作或与屏气相结合时的心率反应，以确定在何种条件下它可作为一种标准化、简单、无创且可重复的副交感神经活动测试。2. 对以下程序进行了评估：(a) 在不同肺容量下于空气中屏气10秒；(b) 在不同温度（5、15和25摄氏度）下将面部浸入水中2分钟，通过闭路维持呼吸；(c) 在不同肺容量下将浸入和屏气相结合。三名志愿者在使用硫酸阿托品（0.04毫克/千克体重）进行药理学阻断后重新接受评估。3. 结果表明：(a) 在空气中屏气引发了与肺容量相关的心率反应；(b) 面部浸入水中诱发了短暂性心动过缓，在浸入20至30秒时达到最大值；(c) 在不同温度下浸入所诱发的心动过缓没有明显差异；(d) 浸入和屏气相结合导致心率反应各异，与分别进行的每个操作相比，心动过缓没有增强；(e) 在两名研究对象中，阿托品并未降低浸入所诱发的心动过缓的幅度。4. 在本研究中观察到的反应变异性可能是由于在这些操作过程中同时被激活的多种受体和传入通路。因此，自主传出反应将取决于这些机制相互作用的不可预测的净效应。这是将该测试标准化为评估副交感神经活动的简单且可重复方法的一个限制因素。5. 此外，药理学阻断下获得的结果表明，迷走神经传出机制并非面部无屏气浸入所导致的心动过缓的唯一原因。