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清醒人类中R-R间期和血压的低频自发波动:是压力感受器现象还是中枢现象?

Low-frequency spontaneous fluctuations of R-R interval and blood pressure in conscious humans: a baroreceptor or central phenomenon?

作者信息

Bernardi L, Leuzzi S, Radaelli A, Passino C, Johnston J A, Sleight P

机构信息

Department of Internal Medicine, University of Pavia, Italy.

出版信息

Clin Sci (Lond). 1994 Dec;87(6):649-54. doi: 10.1042/cs0870649.

Abstract
  1. We have tested the hypothesis that the non-respiratory, low-frequency (around 0.1 Hz) fluctuations of heart rate variability are generated by the baroreflexes, but with a delay caused by the slower response of the efferent sympathetic arm, (compared with the vagus), in 11 healthy subjects (mean age +/- SD 27 +/- 5 years). 2. In random order, at the onset of 20 s of apnoea starting at end expiration, we applied either 600 ms neck suction (-40 mmHg) to the carotid sinus region, or no stimulus (anticipation control), or a loud whistle (alerting control), every 60 s, for 30 min. (i.e. 10 of each 'stimulus'). We recorded neck pressure, blood pressure (Finapres), R-R interval (ECG), infra-red plethysmographic skin blood flow and respiration (impedance). By subtracting the alerting response from the neck suction response we obtained the responses caused purely by baroreceptor stimulation. 3. The initial reflex bradycardia and hypotension was followed by arteriolar vasoconstriction, presumably due to recompensation by the baroreflex, and then by a further reflex bradycardia-producing a decaying oscillation of the R-R interval about the control R-R. The period of this damped oscillation was 0.103 +/- 0.024 Hz, similar to the frequency of the low-frequency peak obtained by power spectral analysis of heart rate variability (0.093 +/- 0.016 Hz, not significant) at rest. These two values were significantly correlated in individual subjects (r = 0.715, P < 0.025). 4. These findings support the hypothesis that the low-frequency waves of heart rate variability can be generated from baroreceptor sensed blood pressure fluctuations.
摘要
  1. 我们在11名健康受试者(平均年龄±标准差27±5岁)中检验了这样一个假设,即心率变异性的非呼吸性低频(约0.1赫兹)波动是由压力反射产生的,但由于传出交感神经臂(与迷走神经相比)反应较慢而存在延迟。2. 以随机顺序,在呼气末开始的20秒呼吸暂停开始时,我们每隔60秒对颈动脉窦区域施加600毫秒的颈部抽吸(-40毫米汞柱),或不施加刺激(预期对照),或吹一声响亮的口哨(警觉对照),持续30分钟。(即每种“刺激”各10次)。我们记录了颈部压力、血压(Finapres)、R-R间期(心电图)、红外体积描记法测量的皮肤血流和呼吸(阻抗)。通过从颈部抽吸反应中减去警觉反应,我们得到了纯粹由压力感受器刺激引起的反应。3. 最初的反射性心动过缓和低血压之后是小动脉血管收缩,推测是由于压力反射的重新代偿,然后是进一步的反射性心动过缓,导致R-R间期围绕对照R-R产生衰减振荡。这种阻尼振荡的周期为0.103±0.024赫兹,与静息时通过心率变异性功率谱分析获得的低频峰值频率(0.093±0.016赫兹,无显著差异)相似。在个体受试者中,这两个值显著相关(r = 0.715,P < 0.025)。4. 这些发现支持了这样一种假设,即心率变异性的低频波可由压力感受器感知的血压波动产生。

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