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健康和轻度高血压受试者在静息和动态运动时对短暂高氧的血流动力学反应。

Hemodynamic responses to brief hyperoxia in healthy and in mild hypertensive human subjects in rest and during dynamic exercise.

作者信息

Izdebska E, Izdebski J, Trzebski A

机构信息

Department of Physiology, Medical Academy of Warsaw, Poland.

出版信息

J Physiol Pharmacol. 1996 Jun;47(2):243-56.

PMID:8807552
Abstract

Hemodynamic consequences of the withdrawal of arterial chemoreceptor drive (ACD) by brief systemic hyperoxia were studied in 16 mild hypertensive subjects (HT) and in 16 healthy subjects (NT) in horizontal position at resting metabolic rate. In another 9 mild HT and match NT measurements were made in resting sitting position and during steady-state mild physical exercise on cycloergometer, (30% of VO2 max.) Tidal volume, minute ventilation, end tidal CO2 and O2 concentration, K+, Na+, pO2, pCO2 values in blood were recorded. Impedance reography was used for recording stroke volume (SV) and arm blood flow (ABF). Cardiac output (CO), ABF and arterial blood pressure (ABF) values were used for calculation of the total peripheral resistance (TPR) and vascular resistance in the arm (AVR). To assess the neurogenic circulatory response to withdrawal of ACD in HT attenuated by opposite peripheral effects of high oxygen, the values of AVR, ABP, TPR and AVR changes during brief hyperoxia in NT, assumed to be of peripheral origin, were subtracted from respective values in HT, assumed to be of mixed neurogenic and peripheral origin. In HT hyperoxia applied in sitting position produced a brief decrease in systolic and diastolic ABP by 5.4 +/- 0.8% and 3.4 +/- 1.1% respectively, of TPR by 12.4 +/- 3% and of AVR by 4.7 +/- 4.6%. Decrease in AVR during hyperoxia was significantly greater in sitting than in horizontal position. In NT hyperoxia produced opposite effects in ABP, TPR and AVR, as compared to those in HT. In HT subjects during steady-state exercise the TPR decreased by 21 +/- 3.7% reaching a value no different from that in NT. We suggest, that in primary hypertension neurogenic sympathoexcitatory ACD is augmented and interacts with the peripheral mechanisms related to tissue oxygen supply.

摘要

在静息代谢率水平下,对16名轻度高血压受试者(HT)和16名健康受试者(NT)处于水平位时,通过短暂全身性高氧去除动脉化学感受器驱动(ACD)的血流动力学后果进行了研究。另外,对9名轻度HT受试者和匹配的NT受试者在静息坐姿以及在蹬车测力计上进行稳态轻度体育锻炼期间(最大摄氧量的30%)进行了测量。记录了潮气量、分钟通气量、呼气末二氧化碳和氧气浓度、血液中的钾离子、钠离子、氧分压、二氧化碳分压值。采用阻抗血流图记录每搏输出量(SV)和手臂血流量(ABF)。心输出量(CO)、ABF和动脉血压(ABP)值用于计算总外周阻力(TPR)和手臂血管阻力(AVR)。为了评估在HT中因高氧相反的外周效应而减弱的对去除ACD的神经源性循环反应,将NT中短暂高氧期间假定为外周起源的AVR、ABP、TPR和AVR变化值从HT中假定为神经源性和外周混合起源的相应值中减去。在HT中,坐姿下应用高氧导致收缩压和舒张压ABP分别短暂下降5.4±0.8%和3.4±1.1%,TPR下降12.4±3%,AVR下降4.7±4.6%。高氧期间AVR的下降在坐姿时明显大于水平位时。与HT相比,在NT中高氧对ABP、TPR和AVR产生相反的影响。在HT受试者稳态运动期间,TPR下降21±3.7%,达到与NT无差异的值。我们认为,在原发性高血压中,神经源性交感神经兴奋性ACD增强,并与与组织氧供应相关的外周机制相互作用。

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