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年龄会改变心血管系统对直接被动加热的反应。

Age alters the cardiovascular response to direct passive heating.

作者信息

Minson C T, Wladkowski S L, Cardell A F, Pawelczyk J A, Kenney W L

机构信息

Noll Physiological Research Center, Pennsylvania State University, University Park, Pennsylvania 16802-6900, USA.

出版信息

J Appl Physiol (1985). 1998 Apr;84(4):1323-32. doi: 10.1152/jappl.1998.84.4.1323.

Abstract

During direct passive heating in young men, a dramatic increase in skin blood flow is achieved by a rise in cardiac output (Qc) and redistribution of flow from the splanchnic and renal vascular beds. To examine the effect of age on these responses, seven young (Y; 23 +/- 1 yr) and seven older (O; 70 +/- 3 yr) men were passively heated with water-perfused suits to their individual limit of thermal tolerance. Measurements included heart rate (HR), Qc (by acetylene rebreathing), central venous pressure (via peripherally inserted central catheter), blood pressures (by brachial auscultation), skin blood flow (from increases in forearm blood flow by venous occlusion plethysmography), splanchnic blood flow (by indocyanine green clearance), renal blood flow (by p-aminohippurate clearance), and esophageal and mean skin temperatures. Qc was significantly lower in the older than in the young men (11.1 +/- 0.7 and 7.4 +/- 0.2 l/min in Y and O, respectively, at the limit of thermal tolerance; P < 0. 05), despite similar increases in esophageal and mean skin temperatures and time to reach the limit of thermal tolerance. A lower stroke volume (99 +/- 7 and 68 +/- 4 ml/beat in Y and O, respectively, P < 0.05), most likely due to an attenuated increase in inotropic function during heating, was the primary factor for the lower Qc observed in the older men. Increases in HR were similar in the young and older men; however, when expressed as a percentage of maximal HR, the older men relied on a greater proportion of their chronotropic reserve to obtain the same HR response (62 +/- 3 and 75 +/- 4% maximal HR in Y and O, respectively, P < 0.05). Furthermore, the older men redistributed less blood flow from the combined splanchnic and renal circulations at the limit of thermal tolerance (960 +/- 80 and 720 +/- 100 ml/min in Y and O, respectively, P < 0. 05). As a result of these combined attenuated responses, the older men had a significantly lower increase in total blood flow directed to the skin.

摘要

在年轻男性进行直接被动加热期间,心输出量(Qc)的增加以及来自内脏和肾血管床的血流重新分布,使得皮肤血流显著增加。为了研究年龄对这些反应的影响,对7名年轻男性(Y组,23±1岁)和7名老年男性(O组,70±3岁)使用水灌注服进行被动加热,直至他们各自的热耐受极限。测量指标包括心率(HR)、Qc(通过乙炔再呼吸法)、中心静脉压(通过外周插入中心静脉导管)、血压(通过肱动脉听诊)、皮肤血流(通过静脉阻断体积描记法测量前臂血流增加量)、内脏血流(通过吲哚菁绿清除率)、肾血流(通过对氨基马尿酸清除率)以及食管温度和平均皮肤温度。尽管食管温度和平均皮肤温度的升高以及达到热耐受极限的时间相似,但老年男性的Qc显著低于年轻男性(在热耐受极限时,Y组和O组分别为11.1±0.7和7.4±0.2升/分钟;P<0.05)。较低的每搏输出量(Y组和O组分别为99±7和68±4毫升/次搏动,P<0.05),很可能是由于加热期间心肌收缩功能增强减弱,这是老年男性Qc较低的主要因素。年轻男性和老年男性的心率升高相似;然而,当以最大心率的百分比表示时,老年男性依靠更大比例的变时储备来获得相同的心率反应(Y组和O组分别为最大心率的62±3和75±4%,P<0.05)。此外,在热耐受极限时,老年男性从内脏和肾循环总和中重新分配的血流较少(Y组和O组分别为960±80和720±100毫升/分钟,P<0.05)。由于这些综合减弱的反应,老年男性流向皮肤的总血流增加量显著较低。

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