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人体血容量分布变化时颈动脉窦对血压和心率的调节能力

Blood pressure and heart rate regulating capacity of the carotid sinus during changes in blood volume distribution in man.

作者信息

Bevegård S, Castenfors J, Lindblad L E, Tranesjö J

出版信息

Acta Physiol Scand. 1977 Mar;99(3):300-12. doi: 10.1111/j.1748-1716.1977.tb10383.x.

Abstract

The influence of changes in blood volume distribution on the carotid baroreflex was studied in 18 subjects. Blood volume distribution was changed by varying the pressure around the lower body above and below ambient, thereby varying the amount of blood pooled in this region and exerting a secondary influence on the central blood volume. The carotid arterial stretch receptors were stimulated by varying the pressure in air-tight box enclosing the neck. To obtain a standardized carotid sinus stimulus (SCS) the pressure in the box was varied sinusoidally between - 10 and - 40 mmHg with a fixed freqency of 0.03 Hz. The effects on heart rate and blood pressure were assessed by harmonic analysis performed off-line on a digital computer. During lower body negative pressure of -40 mmHg (LBNP -40), i.e. during a procedure known to reduce the central blood volume, SCS induced an augmented effect on the blood pressure regulating capacity but not on the heart rate response. Expressing the blood pressure regulating capacity as peak-to-peak changes in systolic arterial pressure, the response during LBNP -40 mmHg was almost twice the control value. The opposite stimulus-lower body postive pressure-influenced the SCS-induced effects only slightly but on the average a minor reduction in both blood pressure and heart rate regulating capacity was found compared with the control condition, though the difference did not reach significant levels. The results support the hypothesis that changes in blood volume distribution modify the function of the carotid baroreflex, possibly via intrathoracic receptors sensitive to changes in central blood volume and/or central venous pressure.

摘要

在18名受试者中研究了血容量分布变化对颈动脉压力反射的影响。通过改变下半身周围高于和低于环境压力的压力来改变血容量分布,从而改变积聚在该区域的血量,并对中心血容量产生间接影响。通过改变包围颈部的密封箱内的压力来刺激颈动脉牵张感受器。为了获得标准化的颈动脉窦刺激(SCS),箱内压力在-10至-40 mmHg之间以0.03 Hz的固定频率进行正弦变化。通过在数字计算机上离线进行的谐波分析来评估对心率和血压的影响。在-40 mmHg的下半身负压(LBNP -40)期间,即在已知会减少中心血容量的过程中,SCS对血压调节能力产生增强作用,但对心率反应没有影响。将血压调节能力表示为收缩期动脉压的峰峰值变化,LBNP -40 mmHg期间的反应几乎是对照值的两倍。相反的刺激——下半身正压——对SCS诱导的效应影响较小,但与对照条件相比,平均发现血压和心率调节能力略有降低,尽管差异未达到显著水平。结果支持以下假设:血容量分布的变化可能通过对中心血容量和/或中心静脉压变化敏感的胸腔内感受器来改变颈动脉压力反射的功能。

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