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突然平静性低氧血症期间脾脏收缩会提高血红蛋白浓度。

Spleen Contraction During Sudden Eupneic Hypoxia Elevates Hemoglobin Concentration.

作者信息

Pernett Frank, Schagatay Felix, Vildevi Caroline, Schagatay Erika

机构信息

Department of Health Sciences, Mid Sweden University, Östersund, Sweden.

Scandinavian Aviation Academy, Västerås, Sweden.

出版信息

Front Physiol. 2021 Sep 21;12:729123. doi: 10.3389/fphys.2021.729123. eCollection 2021.

Abstract

The spleen contracts progressively during moderate normobaric hypoxia exposure of 20 min, which elevates hemoglobin concentration (Hb). However, acute hypoxia exposure could be shorter and more severe when oxygen systems fail during, e.g., high-altitude sky diving, aircraft cabin pressure drop, balloon flights, extreme altitude climbing, and in some maladies. We aimed to evaluate the speed and magnitude of spleen contraction during short exposure to extreme eupneic hypoxia and its subsequent recovery on oxygen. Eight female and seven male volunteers were exposed to normobaric hypoxia (10% oxygen) for 10 min during sitting rest, followed by 10 min on 100% oxygen. Heart rate (HR), arterial oxygen saturation (SpO), and mean arterial blood pressure (MAP) were measured continuously. The spleen was measured via ultrasonic imaging every minute for volume calculations, and venous blood samples were drawn before and after exposure for hemoglobin concentration (Hb). Mean (SD) spleen volume was 279 (115) mL before exposure, 219 (75) mL (21% reduction; = 0.005) at 3 min of exposure, and 201 (93) mL after 10 min exposure to hypoxia (28% reduction; < 0.001). Hb was 138.8 (7.6) g·L before and 142.9 (8.1) g·L after 10 min of exposure (2.9% increase; < 0.001). SpO was 96.4 (1.7)% before exposure and 74.7 (8.4)% during the last minute of exposure (22.5% reduction; < 0.001). HR increased from 80 (14) to 90 (17) bpm during exposure (12% increase, < 0.05). MAP remained unchanged. After 10 min recovery on oxygen, values had been restored for spleen volume and Hb, while SpO was higher and HR lower compared with before hypoxia exposure. We concluded that acute normobaric hypoxia of only 10 min caused significant spleen volume contraction with Hb increase. This rapid spleen response, evident already after 3 min of exposure, could have a protective effect during sudden exposure to severe hypoxia.

摘要

在20分钟的中度常压缺氧暴露过程中,脾脏会逐渐收缩,这会提高血红蛋白浓度(Hb)。然而,当氧气系统在例如高空跳伞、飞机机舱压力下降、气球飞行、极端海拔攀登以及某些疾病期间出现故障时,急性缺氧暴露可能会更短且更严重。我们旨在评估在短时间暴露于极端平静性缺氧期间脾脏收缩的速度和幅度以及随后吸氧后的恢复情况。八名女性和七名男性志愿者在静息坐姿下暴露于常压缺氧(10%氧气)环境10分钟,随后吸入100%氧气10分钟。连续测量心率(HR)、动脉血氧饱和度(SpO)和平均动脉血压(MAP)。通过超声成像每分钟测量一次脾脏以计算体积,并在暴露前后采集静脉血样以测定血红蛋白浓度(Hb)。暴露前脾脏平均(标准差)体积为279(115)mL,暴露3分钟时为219(75)mL(减少21%;P = 0.005),暴露于缺氧10分钟后为201(93)mL(减少28%;P < 0.001)。暴露前Hb为138.8(7.6)g·L,暴露10分钟后为142.9(8.1)g·L(增加2.9%;P < 0.001)。暴露前SpO为96.4(1.7)%,暴露最后一分钟时为74.7(8.4)%(减少22.5%;P < 0.001)。暴露期间HR从80(14)次/分钟增加到90(17)次/分钟(增加12%,P < 0.05)。MAP保持不变。吸氧恢复10分钟后,脾脏体积和Hb的值已恢复,而与缺氧暴露前相比,SpO更高,HR更低。我们得出结论,仅10分钟的急性常压缺氧会导致脾脏体积显著收缩并使Hb增加。这种快速的脾脏反应在暴露3分钟后就很明显,可能在突然暴露于严重缺氧期间具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3d1/8490696/834f3e0b6e94/fphys-12-729123-g0001.jpg

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