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卧床休息和太空飞行早期数小时内心血管功能的比较。

Comparison of cardiovascular function during the early hours of bed rest and space flight.

作者信息

Lathers C M, Charles J B

机构信息

NASA/Johnson Space Center, Space Biomedical Research Institute, Houston, Texas.

出版信息

J Clin Pharmacol. 1994 May;34(5):489-99. doi: 10.1002/j.1552-4604.1994.tb04992.x.

Abstract

This paper reviews the cardiovascular responses of six healthy male subjects to 6 hours in a 5 degrees head-down bed rest model of weightlessness, and compares these responses to those obtained when subjects were positioned in head-up tilts of 10 degrees, 20 degrees, and 42 degrees, simulating 1/6, 1/3, and 2/3 G, respectively. Thoracic fluid index, cardiac output, stroke volume, and peak flow were measured using impedance cardiography. Cardiac dimensions and volumes were determined from two-dimensional guided M-mode echocardiograms in the left lateral decubitus position at 0, 2, 4, and 6 hours. Cardiovascular response to a stand test were compared before and after bed rest. The impedance values were related to tilt angle for the first 2 hours of tilt; however, after 3 hours, at all four angles, values began to converge, indicating that cardiovascular homeostatic mechanisms seek a common adapted state, regardless of effective gravity level (tilt angle) up to 2/3 G. Echocardiography revealed that left ventricular end-diastolic and end-systolic volume, stroke volume, ejection fraction, heart rate, and cardiac output had returned to control values by hour 6 for all tilt angles. The lack of a significant immediate change in left ventricular end-diastolic volume, despite decrements in stroke volume (P < .05) and heart rate (not significant), indicates that multiple factors may play a role in the adaptation to simulated hypogravity. The echocardiography data indicated that no angle of tilt, whether head-down or head-up for 4 to 6 hours, mimicked exactly the changes in cardiovascular function recorded after 4 to 6 hours of space flight. Changes in left ventricular end-diastolic volume during space flight and tilt may be similar, but follow a different time course. Nevertheless, head-down tilt at 5 degrees for 6 hours mimics some (stroke volume, systolic and diastolic blood pressure, mean arterial blood pressure, and total resistance), but not all, of the changes occurring in an equivalent time of space flight. The magnitude of the change in the mean heart rate response to standing was greater after six hours of tilt at -5 degrees or 10 degrees. Thus, results from the stand test after 6 hours of bed rest at -5 degrees and 10 degrees, but not at 20 degrees or 42 degrees, are similar to those obtained after space flight.

摘要

本文回顾了6名健康男性受试者在5度头低位卧床失重模型中6小时的心血管反应,并将这些反应与受试者分别处于10度、20度和42度头高位倾斜(分别模拟1/6、1/3和2/3 G)时获得的反应进行比较。使用阻抗心动图测量胸液指数、心输出量、每搏输出量和峰值流量。在左侧卧位于0、2、4和6小时通过二维引导M型超声心动图确定心脏尺寸和容积。比较卧床休息前后对站立试验的心血管反应。在倾斜的前2小时,阻抗值与倾斜角度相关;然而,3小时后,在所有四个角度,数值开始趋同,表明心血管稳态机制寻求一种共同的适应状态,无论有效重力水平(倾斜角度)高达2/3 G。超声心动图显示,对于所有倾斜角度,在6小时时左心室舒张末期和收缩末期容积、每搏输出量、射血分数、心率和心输出量已恢复到对照值。尽管每搏输出量下降(P < 0.05)且心率无显著变化,但左心室舒张末期容积缺乏显著的即时变化,这表明多种因素可能在对模拟低重力的适应中起作用。超声心动图数据表明,无论是4至6小时的头低位还是头高位倾斜,没有一个角度能完全模拟4至6小时太空飞行后记录的心血管功能变化。太空飞行和倾斜期间左心室舒张末期容积的变化可能相似,但时间进程不同。然而,5度头低位倾斜6小时模拟了太空飞行相同时间内发生的一些变化(每搏输出量、收缩压和舒张压、平均动脉压和总阻力),但不是全部。在 -5度或10度倾斜6小时后,对站立的平均心率反应变化幅度更大。因此,在 -5度和10度卧床休息6小时后站立试验的结果与太空飞行后获得的结果相似,但在20度或42度时则不然。

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