累加角度头高斜位下心率、血压、心率变异性与脑血流变化的特征

目的探讨累加角度头高斜位暴露下 ,正常人体血压、心率、脑血流及心率变异性 (HRV)变化特征 ,为建立飞行员晕厥检查的方法学提供生理依据。方法采用自行研制的多功能双向式医用倾斜床 ,结合先进的十二导联同步心电图描记方法和经颅多普勒脑血流成像技术进行累加角度 ( + 4 5°→ 60°→75°)头高斜位 (HUT)暴露下的心率、血压、HRV和脑血流速率的测量与分析。结果 1 )随着倾斜角度加大 ,暴露时程延长 ,HR逐渐增快 ,SBP逐渐下降 ,DBP逐渐升高 ,PP逐渐缩小 ,与暴露前比较 ,HR、PP和DBP相差非常显著 (P <0 .0 5 ) ;脑血流速率 (包括 :Vs、Vm、Vd)逐渐下降 ,无论与暴露前比 ,或倾斜角度之间比 ,差异十分显著 (P <0 .0 1 ) ;mRR和sdRR逐渐减小。 2 )生理指标与技术指标直线相关分析发现 :在 1min时 ,SBP、DBP、MAP、Vd、sdRR与倾斜角度呈明显正相关 (P <0 .0 1 ) ;在 2 0min时 ,HR和sdRR与倾斜角度呈明显正相关 (P <0 .0 1 ) ,与SBP、PP、Vs、mRR明显负相关 (P <0 .0 1 ) ;暴露时程与HR呈明显正相关 (P <0 .0 1 ) ,与SBP、Vm、Vd、mRR呈明显负相关 (P <0 .0 1 )。 3)生理指标间相关分析发现 :HR与SBP、Vs、Vm、Vd 呈明显负相关 (P <0 .0 1 ) ;SBP与Vd 和mRR呈明显正相关 (P <0 .0 1 ) ;Vs、Vm、Vd 与mRR和sdR

Features of Heart Rate, Blood Pressure, Heart Rate Variability and Cerebral Blood Flow during Sequential Head-up Tilt Test

Objective: To investigate the features of BP, HR, cerebral blood flow (CBF) and heart rate variation (HRV) during sequential head-up tilt table test (HUT) and provide information for methodology of testing tendency to syncope in pilots. Method: Sixteen healthy male were exposed to HUT +45 degrees 20 min, +60 degrees 20 min, and +75 degrees 20 min respectively with 5 min rests in between. CBFV, HR, HRV, BP were measured with transcranial doppler image (TCI), 12-Lead in phase ECG. Result: 1) As the tilt angle became larger, HR and DBP increased gradually (P<0.05), with SBP, PP and CBF Velocity (Vs,Vm,Vd) descended. There were significant differences among the various conditions. CV became smaller before +75 degrees, and then it began to increase. 2) Correlation between physiological indices and techno-indices were analyzed. At the point of 1 min, tilt angle was significantly positively correlated with SBP, DBP, MAP, Vd, and sdRR (P<0.01); At the point of 20 min, tilt angle was significantly positively correlated with HR and sdRR (P<0.01), but negatively correlated with SBP, PP, Vs and mRR (P<0.01), time of exposure was positively correlated with HP (P< 0.01), but negatively correlated with Vm, Vd, and mRR (P<0.01). 3) Correlation among physiological indices were also analyzed. HR were negatively correlated with SBP, Vs, Vm and Vd (P<0.01), SBP were significantly positively correlated with Vd, and mRR (P<0.01). Vs, Vm, Vd were significantly positively correlated with mRR and sdRR (P< 0.01). Conclusion: By investigating HR, BP, HRV and CBFV during of different angles, some advises for evaluating the tendency to syncope in pilots were put forward.