Effect of lower body negative pressure against orthostatic intolerance induced by 21 days head-down tilt bed rest

BACKGROUND: Exposure to actual or simulated weightlessness is known to induce orthostatic intolerance in humans. Many different methods have been suggested to counteract orthostatic hypotension. The repetitive or prolonged application of lower body negative pressure (LBNP) has shown beneficial effects to counter orthostatic intolerance, but devoting so much time to countermeasures is not compatible with space mission objectives or costs. The purpose of the present study was to assess the effects of brief LBNP sessions against orthostatic intolerance during a 21-d head-down tilt (HDT) bed rest. METHODS: There were 12 healthy male volunteers who were exposed to -6 degrees HDT bed rest for 21 d. Six subjects received -30 mm Hg LBNP sessions for 1 h x d(-1) from day 15 to day 21 of the HDT, and six others served as control. Orthostatic tolerance was assessed by means of standard tilt test. RESULTS: Before HDT, all the subjects in the two groups completed the tilt tests. After 21 d of HDT, five subjects of the control group and one subject of the LBNP group could not complete the tilt test due to presyncopal or syncopal symptoms. The mean upright time in the control group 13.0 +/- 4.0 min) was significantly shorter (p < 0.05) than that in the LBNP group (19.0 +/- 2.2 min). Body weight decreased significantly in the control group during HDT, while increasing significantly on day 21 of HDT in the LBNP group. Urine volume increased on days 15-21 of HDT in the control group, but remained unchanged throughout HDT in the LBNP group. A significant decrease in cardiac output and cardiac index, and a significant increase in total peripheral resistance, pre-ejection period, plasma renin activity, aldosterone, and prostaglandin 12 were observed during HDT in both groups. There were no significant differences in these parameters between the two groups. CONCLUSIONS: Brief daily LBNP sessions were effective in preventing orthostatic intolerance induced by 21 d HDT bed rest. However, it did not improve cardiac pump and systolic functions and did not preserve volume regulating hormones.     

21d头低位卧床期问脑血流的变化及最后一周下体负压锻炼的影响

目的观察 2 1d头低位卧床期间脑血流的变化及最后一周下体负压对抗的影响。方法 1 2名健康男性志愿者 ,随机分为对照组和LBNP组 ,每组 6人 ,进行头低位倾斜卧床 ( - 6°)。对照组在卧床期间不做任何处理 ,LBNP组在卧床最后一周 ,每天进行 1h、- 4.0kPa的下体负压锻炼。利用KYENG Ⅰ导纳式双侧脑血流自动检测仪测量卧床前、卧床第 3、1 0及 2 1天的脑血流量。结果对照组的左侧大脑Ⅰ相面积及流入速度在卧床期间较卧床前均显著降低 ,左侧大脑主峰高度在卧床第 3及 2 1天显著降低 ,左侧大脑阻力指数在卧床第 3及 2 1天显著升高 ;LBNP组的左侧大脑Ⅰ相面积在卧床第 3及 2 1天较卧床前均显著降低 ,左侧大脑阻力指数在卧床期间均显著升高 ,左侧大脑主峰高度及流入速度在卧床第 3及 2 1天有降低趋势 ,但未达到显著水平。两组之间比较无显著性差异。结论 2 1d头低位卧床可引起脑血管阻力增加 ,脑血流量减少 ;在 2 1d头低位卧床的最后一周进行下体负压锻炼 ,不能有效地对抗头低位卧床模拟失重引起的脑血流的变化。     

Results of a 4-week head-down tilt with and without LBNP countermeasure: I. Volume regulating hormones.

The volume regulating hormones were studied during a 4-week head-down tilt (CNES HDT) in five subjects with and without (controls) lower body negative pressure (LBNP). LBNP was applied 3 times a day for 3 weeks, 4 times a day for 4 d, and 6 times a day for 3 d the last week. In both groups we observed a significant decrease in body weight (3% in controls, 0.8% in LBNP), a significant increase in plasma renin activity and aldosterone (with an amplification of their rhythms), and a significant decrease in norepinephrine with no difference between the two groups. The only major hormonal difference was observed for atrial natriuretic factor (ANF), which decreased significantly in the control group and increased in the LBNP group. These results are compared with the improvement in orthostatic tolerance (OT) after HDT in the LBNP group in the same protocol (17). We conclude that many factors could be involved in the improvement of OT. The results suggest that better conservation of plasma volume in the LBNP group might have prevented a decrease in ANF. Whether ANF plays a role in the regulation of baroreceptor reflex with an improvement in OT is currently unknown.     

21d头低位卧床期间第一周和最后一周下体负压锻炼对立位耐力和心功能的影响

目的观察在 2 1d头低位卧床的第一周和最后一周进行下体负压锻炼对立位耐力和心功能的影响。方法 1 2名健康男性志愿者 ,随机分为对照组和LBNP组 ,每组 6人 ,均参加 - 6°头低位倾斜卧床实验。对照组在卧床期间不做任何处理 ,LBNP组在卧床第一周和最后一周 ,每天进行 1h、- 30mmHg的下体负压锻炼。卧床前和卧床第 1 0、2 1天在倾斜床上进行 3次立位耐力检查 ,卧床期间测量心脏泵血和收缩功能等指标。结果卧床前两组 1 2名被试者均顺利通过立位耐力检查。卧床第 1 0和 2 1天 ,对照组所有被试者均不能通过立位耐力检查 ,而下体负压组仅有 1人未通过 ,卧床第 2 1天下体负压组( 1 9.7± 0 .9min)平均耐受时间较对照组 ( 1 5 .0± 3.2min)显著延长 (P <0 .0 5 )。对照组每搏输出量(SV)及心输出量 (CO)在卧床第 3、1 0天较卧床前显著降低 (P <0 .0 5 ) ,而LBNP组SV及CO在卧床期间均无显著性变化 ;两组的射血前期 (PEP) /左室射血时间 (LVET)在卧床第 3、1 4天均显著升高 (P <0 .0 5 )。两组间比较 ,LBNP组PEP/LVET在卧床第 3天较对照组显著降低 (P <0 .0 5 ) ,LVET在卧床第 3、7和 1 4天较对照组显著升高 (P <0 .0 5 )。结论 2 1d头低位卧床可引起立位耐力、心脏泵血和收缩功能显著降低 ;在 2 1d头低位卧床的     

下体负压对抗21d头低位卧床后立位耐力不良的研究

目的观察ＬＢＮＰ对２１ｄＨＤＴ－６°卧床模拟失重所致立位耐力不良的对抗效果。方法１２名健康男性青年志愿者,进行２１ｄＨＤＴ－６°卧床实验。随机分为对照组和下体负压组,每组６人。与对照组不同,下体负压组在最后一周,每天进行１ｈ、－４．０ｋＰａ的下体负压锻炼。结果卧床前,１２名受试者顺利通过７５°、２０ｍｉｎ立位耐力检查。卧床第１０ｄ立位耐力检查时,对照组有５人、ＬＢＮＰ组有４人出现晕厥前或晕厥症状,两组平均耐受时间均低于卧床前（Ｐ＜０．０５）;第２１ｄ时,对照组有５人未通过,平均耐受时间较卧床前显著降低（Ｐ＜０．０５）;而ＬＢＮＰ组有１人未通过,平均耐受时间显著高于对照组（Ｐ＜０．０５）。结论２１ｄ头低位卧床后立位耐力显著降低。下体负压能够有效对抗头低位卧床导致的立位耐力降低。     

4d头低位卧床期间脑血流速度的改变

目的观察 4d头低位卧床模拟失重期间大脑中动脉血流速度的变化。方法 8名健康男性志愿者进行 4d - 6°头低位卧床试验。卧床前和卧床 4d结束时在倾斜床上进行 2次立位耐力检查 ,卧床前(卧位 )、卧床第 1、3、4天及起床后第 2天用经颅多普勒超声仪测量右侧大脑中动脉血流速度。结果 4d卧床结束时 ( 87.5 % )被试者立位耐力不良发生率较卧床前 ( 37.5 % )显著增加 (P <0 .0 5 )。大脑中动脉收缩期血流速度、舒张期血流速度和平均血流速度在卧床第 1、3天较卧床前均有降低趋势 ,但未达到显著水平 ,卧床第 4天均显著降低 (P <0 .0 5 ) ,起床后第 2天基本恢复。在卧床期间 ,平均动脉压及舒张压均显著升高 (P <0 .0 5 ) ,体重显著降低 (P <0 .0 5 )。结论 4d头低位卧床可引起大脑中动脉血流速度显著降低 ,立位耐力不良发生率增加。脑血流速度降低可能是失重 /模拟失重致立位耐力不良的机制之一     

坐位下体负压下人体大脑中动脉血流速度及血氧饱和度的改变

目的探讨坐位下体负压对人体大脑中动脉血流速度、心率和血氧饱和度的影响。方法 15名健康青年男性在坐位下体负压 - 4.0 0kPa、 - 6.67kPa条件下 ,分别测试负压前、下体负压暴露 0 .5、1、2、3、4、5min和卸压后 1、3、5min的大脑中动脉血流速度、心率和血氧饱和度。结果在 - 4.0kPa下体负压作用 4、5min时 ,脑血流速度减慢 (P <0 .0 5 ) ;负压作用 3、4、5min时心率增快 (P <0 .0 5 ) ;血氧饱和度无明显改变。在 - 6.67kPa下体负压作用 2、3min时 ,脑血流速度减慢 (P <0 .0 5 ) ,在 4min和 5min时显著减慢 (P <0 .0 1) ,卸压后 1min尚未恢复 (P <0 .0 5 ) ,随后恢复至对照水平 ;负压作用后各时间点心率均显著增快 (P <0 .0 1) ;血氧饱和度在负压暴露 5min时显著下降 (P <0 .0 5 )。结论坐位下体负压造成血液在下肢淤积 ,大脑中动脉血流速度减慢 ,引起大脑血供减少 ,为空中晕厥和立位耐力不良的医学鉴定提供了人体实验依据     

Hypovolemic intolerance to lower body negative pressure in female runners.

PURPOSE: An attenuated baroreflex response and orthostatic intolerance have been reported in endurance-trained male athletes; however, it is still unknown whether this occurs also in females. The purpose of the present study was to examine whether endurance exercise-trained women had a predisposition to orthostatic compromise, and if so, what causative factor(s) may induce orthostatic intolerance. METHODS: We studied cardiovascular and hormonal responses to graded lower body negative pressure (LBNP) (0 to -60 mm Hg) in 26 middle-distance female runners (18.6 +/- 0.1 yr) as the exercise-trained (ET) subjects and 23 age-matched untrained (UT) control subjects. On the basis of the occurrence of syncope episodes during LBNP, ET and UT subjects were further allocated to two groups; ET with presyncope (ET+syncope) and without presyncope (ET-syncope) and UT with presyncope (UT+syncope) and without presyncope (UT-syncope). RESULTS: Occurrence of presyncope episodes during LBNP was higher in ET (65.4%, P < 0.05) than that for UT (34.8%). Leg compliance was higher (P < 0.05) in ET than in UT. LBNP reduced stroke volume (SV) more (P < 0.05), increased heart rate (HR) higher (P < 0.05), and increased forearm vascular resistance (FVR) more in ET+syncope as compared with the other groups. Response of vasoactive hormones to LBNP was higher in ET+syncope (P < 0.05) than that of the other groups except for norepinephrine (NE); high in both ET+syncope and UT+syncope. The relationship between SV and NE, an index of sympathetic neuronal response, had no training-related changes during LBNP. CONCLUSION: We conclude that exercise-trained females have a high incidence of orthostatic intolerance during LBNP, with a greater reduction of SV independent of changes in baroreflex and neurohumoral function. A lower incidence of LBNP intolerance in UT may be accounted for by a lower reduction of SV during LBNP. An increase in leg compliance in the exercise-trained females may play an important role in inducing pronounced reduction of SV and hence the intolerance to LBNP.     

21d头低位卧床期间心功能的变化及最后一周下体负压锻炼的影响

目的 观察21d头低位卧床期间被试者心功能的变化及最后一周下体负压锻炼（LBNP）的影响。方法 12名健康男性志愿者,随机分为对照组和LBNP组,每组6人,均参加头低位倾斜卧床实验。对照组在卧床期间不做任何处理,LBNP组在卧床最后一周,每天进行1h、－4．0kPa的下体负压锻炼。测量心脏收缩和泵血功能等指标。结果 在卧床期间,两组的心输出量、心指数及每搏输出量较卧床前均显著降低或有降低趋势,射血前期（PEP）均显著延长,总外周阻力、等容收缩时间／左室射血时间（LVET）、PEP／LVET均显著升高而有升高趋势,起床后第2天基本恢复。LBNP组PEP和PEP／LVET在第21天及起床后第2天较对照组显著升高。结论 21d头低位卧床可引起心脏泵血和收缩功能显著降低;在21d头低位卧床的最后一周进行下体负压锻炼,不能有效对抗头低位卧床模拟失重引起的心脏泵血和收缩功能的降低,但对提高立位耐力有利。     

Bed rest effects on human calf hemodynamics and orthostatic intolerance: a model-based analysis

INTRODUCTION: Microgravity-induced orthostatic intolerance continues to be a primary problem after space missions. Its etiology remains uncertain despite significant research efforts over the past years. We hypothesized that calf hemodynamic parameters (compliance and resistance) are significantly affected by 14 to 16-d head-down bed rest (simulated microgravity), and their alterations play a role in the pathogenesis of orthostatic intolerance (OI) following bed rest. METHODS: To estimate these parameters, we developed a model-based approach to quantitatively simulate calf vascular response to venous occlusion, which only necessitates measurement of plethysmography data. In this study, plethysmography data were obtained from 29 subjects before and after 14-16 d of head-down bed rest. The subjects also underwent a tilt/stand test before and after bed rest. RESULTS: Statistical analyses demonstrated an increase in calf compliance (1.87 +/- 0.08, mean +/- SE, pre-bed rest; 2.16 +/- 0.10, end-bed rest) but no significant change in vascular resistance following bed rest. Compared with the tilt-intolerant subjects, those who were tilt-tolerant before bed rest had significantly higher calf compliance [2.00 +/- 0.09 (tolerant); 1.58 +/- 0.09 (intolerant)] and higher vascular resistance [7.79 +/- 0.18 (tolerant); 6.91 +/- 0.40 (intolerant)]. After bed rest, no such difference was detected. DISCUSSION: Based on these results, we validated the hypothesis that, instead of causing orthostatic intolerance, higher calf compliance before bed rest leads to recruitment of compensatory mechanisms (validated by the enhanced vascular resistance during venous occlusion) for a better toleration of orthostatic stress. With the absence of orthostatic challenge during bed rest, the difference in calf hemodynamic parameters is attenuated between the tilt-tolerant and tilt-intolerant groups.     

21天头低位(-6°)卧床前后下体负压和头高位倾斜暴露时的心血管反应

目的探讨２１天头低位（ＨＤＴ）卧床对人体立位应激下心血管反应的影响,以及比较下体负压（ＬＢＮＰ）和头高位倾斜（ＨＵＴ）两种立位应激下心血管反应的差异。方法６名受试者在２１天ＨＤＴ前、后分别进行ＬＢＮＰ（－４．００ｋＰａ／３ｍｉｎ、－６．６７ｋＰａ／３ｍｉｎ及－９．３３ｋＰａ／３ｍｉｎ）和ＨＵＴ试验（３０°／３ｍｉｎ、４５°／３ｍｉｎ、６０°／３ｍｉｎ及７５°／３ｍｉｎ）,以比较两种检测方法的血压（ＢＰ）和心率（ＨＲ）的变化情况。结果与ＬＢＮＰ（或ＨＵＴ）前相比：①ＬＢＮＰ（ＨＵＴ）时ＨＲ显著增加（Ｐ＜０．０１）,ＳＢＰ显著降低（Ｐ＜０．０５）;卧床后相应的变化量增加。②ＬＢＮＰ时ＤＢＰ降低（卧床后达显著,Ｐ＜０．０５）;而ＨＵＴ时ＤＢＰ增加（卧床后达显著,Ｐ＜０．０５）。③ＬＢＮＰ时ＭＡＰ均显著降低（Ｐ＜０．０５）;而ＨＵＴ时在卧床前无变化（Ｐ＞０．０５）,在卧床后显著增加（Ｐ＜０．０５）。结论ＬＢＮＰ和ＨＵＴ引起的ＣＶＳ反应并不相同。笔者认为,ＨＵＴ更能促进心血管系统对立位应激的调节作用。     

模拟失重对心血管功能的影响及下体负压的对抗作用

总结了近年来本实验室有关模拟失重对心血管功能影响及下体负压对抗作用的研究，讨论了模拟失重致立位耐力不良的机理可能与心血管功能降低，脑血流降低及内分泌改变等有关，以及采用数学模型方法探讨失重致立位耐力降低机制的作用意义，重点论述了下体负压对抗方案问题。     

21d头低位卧床期间脑底动脉血流动力学的变化

目的观察21d头低位卧床期间脑底动脉血流动力学的变化。方法6名健康男性志愿者,年龄24.8±6.1岁,进行了21dHDT-6°卧床试验。HDT前、HDT第10天及卧床结束时进行了3次立位耐力检查。HDT前(坐位)、HDT即刻(D0)、第1、3、7、10、21天用经颅超声多普勒(TCD)测量了双侧大脑前(ACA)、中(MCA)、后动脉(PCA)的血流动力学指标。结果卧床第10天和卧床结束时,受试者立位耐力比卧床前显著降低(P<0.05）。卧床第3天和第21天的右侧MCA的V     

Cardiovascular adaptation during simulated microgravity: lower body negative pressure to counter orthostatic hypotension

The cardiovascular function is one of the main functions disturbed by microgravity. It is particularly affected by the astronaut's return to Earth, where one of the symptoms of the cardiovascular adaptation syndrome is orthostatic hypotension; the clinical consequence can be presyncopal state or a syncope. Lower body negative pressure (LBNP) is intended to stimulate the venous system of the lower limbs. Studies performed in the U.S. have shown that LBNP constitutes an efficient countermeasure, but this approach is impractical because 4 to 6 h/d of application are required. Five volunteers took part in two recent antiorthostatic bed rest experiments for 30 days. In the first experiment, three subjects were submitted to several sessions of LBNP per day and two others were controls; in the second, the LBNP group of the first experiment became control and vice versa. Two orthostatic investigations were performed: 5 d before bed rest; and at the end of the 30-d bed rest period. The results showed that: 1) when the subjects were controls, a high orthostatic hypotension post bed rest with three syncopes and one presyncopal state during the first minutes of the tilt test appeared; 2) when the subjects were submitted to LBNP sessions, no orthostatic hypotension was noted. These two experiments proved the beneficial effects of the LBNP as a countermeasure against orthostatic hypotension.     

Relationship between the hemodynamic disorders in cosmonauts on short-term space flights and orthostatic stability]

Comparative investigation of the hemodynamic responses of cosmonauts at rest, during occlusive leg plethysmography, and LBNP in relatively short (less than a month) space flights were performed to tie up these measurements with post-landing orthostatic stability (OS). The decreased LBNP tolerance in flight that correlated later on with impaired reactions to both active and passive orthostatic testing are attributed, among other reasons, to deficient vasoconstriction of the main arteries and over-extendibility of veins in the lower extremities. Results of ultrasonic investigations of hemodynamics during LBNP tests before and after space flight and data of leg venous extension in SF can and should be used in predicting cosmonaut's orthostatic status post flight.     

头低位卧床7d对立位心肺循环功能的影响

目的观察短期模拟失重对立位心肺循环功能的影响,为进一步研究失重时心血管功能下降机理积累资料。方法６名健康男性被试者,头低位６°卧床７ｄ。分别观察卧床前、后立位心肺循环功能的变化。心肺循环功能检测选用ＸＸＨ－２０００型小循环心功能检测仪。结果头低位卧床７ｄ致被试者立位耐力降低,卧床后右心室射血期（ｊ－ｚ）缩短,右心室排血效率降低（Ｑ－ｊ／ｊ－ｚ升高）,提示右心功能减退。心血管调节适应性反应减弱,右心功能储备降低。结论ｃ波高度（ｈｃ）、ｃ波高度与Ｚ波高度的比值（ｈｃ／ｈｚ）可作为评价立位耐力或预测立位晕厥的指标;小循环心功能检测法评价立位心肺循环功能的变化有一定的前景。     

Lower-body negative-pressure exercise and bed-rest-mediated orthostatic intolerance

PURPOSE: Supine, moderate exercise is ineffective in maintaining orthostatic tolerance after bed rest (BR). Our purpose was to test the hypothesis that adding an orthostatic stress during exercise would maintain orthostatic function after BR. METHODS: Seven healthy men completed duplicate 15-d 6 degrees head-down tilt BR using a crossover design. During one BR, subjects did not exercise (CON). During another BR, subjects exercised for 40 min.d(-1) on a supine treadmill against 50-60 mm Hg LBNP (EX). Exercise training consisted of an interval exercise protocol of 2- to 3-min intervals alternating between 41 and 65% (.)VO(2max). Before and after BR, an LBNP tolerance test was performed in which the LBNP chamber was decompressed in 10-mm Hg stages every 3 min until presyncope. RESULTS: LBNP tolerance, as assessed by the cumulative stress index (CSI) decreased after BR in both the CON (830 +/- 144, pre-BR vs 524 +/- 56 mm Hg.min, post-BR) and the EX (949 +/- 118 pre-BR vs 560 +/- 44 mm Hg.min, post-BR) conditions. However, subtolerance (0 to -50 mm Hg LBNP) heart rates were lower and systolic blood pressures were better maintained after BR in the EX condition compared with CON. CONCLUSION: Moderate exercise performed against LBNP simulating an upright 1-g environment failed to protect orthostatic tolerance after 15 d of BR.     

下体负压旋转床模拟航空推拉效应对心血管功能的影响

目的探讨下体负压旋转床模拟航空推拉效应的效果 ,观察推拉动作对心血管功能的影响。方法 8名被试者在下体负压旋转床上进行“直立位 (HUT ,+1Gz) -倒立位 -直立位 +下体负压 (LBNP ,- 5 0mmHg) 1 0min”的模拟推拉效应试验及单纯直立位 +下体负压 (- 5 0mmHg) 1 0min的对照试验 ,用阻抗法测量了试验过程中心率 (HR)、血压 (BP)、基础阻抗 (Z0 )、每搏心输出量 (SV)、心输出量 (CO)及总外周阻力 (TPR)等心血管功能指标的变化。结果在模拟推拉效应试验中 ,有 3名被试者没有完成直立位 +LB NP作用 1 0min的试验 ,出现晕厥前症状 ,8名被试者平均耐受时间为 8.99± 1 .47min。而对照试验时 ,被试者均完成了 1 0min的直立 +LBNP试验。模拟推拉效应试验时 ,在倒立位 ,被试者HR、Z0 较直立位对照值降低 ,SV和CO较直立位对照值升高 ,均有显著性意义 ;直立位 +LBNP过程中 ,HR、Z0 、TPR较对照和倒立位值显著增高 ,SV和CO较对照和倒立位值显著降低 ,SBP在HUT即刻较对照值显著性增高 ,在HUT +LBNP过程中显著性降低。在对照试验时 ,上述指标呈现出相同的变化 ,但增高或降低的百分比 (% )低于模拟推拉效应试验 (HR除外 )。结论倒立位后 ,再直立 +LBNP作用 ,心血管功能下降程度大于单纯直立 +LBNP作用 ,下体负压旋转床     

头低位暴露后直立位下体负压作用的耐力变化和心血管反应

目的观察头低位后直立位下体负压暴露的耐力和心血管反应。方法8名被试者在下体负压倾斜床上进行“直立位-倒立位30s-直立位联合下体负压(-60mmHg)致晕厥前症状”的模拟推拉效应试验及单纯直立位 下体负压(-60mmHg)致晕厥前症状的对照试验,用阻抗法测量了试验过程中心血管功能指标的变化。结果在模拟推拉效应试验中,8名被试者出现晕厥前症状的平均耐受时间为4.5±2.4min,显著低于对照试验时的8.4±2.1min(P<0.01)。在倒立位,被试者HR较直立位基础值降低,SV和CO较直立位基础值升高,均有显著性意义。和基础值相比,直立位下体负压时HR增加的百分比显著低于对照试验(P<0.05),而直立位下体负压时SV和CO降低的百分比均显著高于对照试验时SV和CO降低的百分比(P<0.05)。在直立位下体负压暴露时,对照试验的PP和基础值比较显著降低(P<0.05),TPR比基础值显著增加(P<0.05)。结论倒立位后,再进行直立位下体负压作用,出现晕厥前症状的平均耐受时间缩短,心血管反应降低。     

心肌收缩功能降低对下体负压效应影响的仿真研究

目的：研究不同程度心肌收缩功能降低对心血管系统立位应激反应的影响，探讨心肌收缩功能改变在航天失重心后心血管失调和立位耐力降低机理中的意义。方法：以我们原有仿真血量减少后下体负压（LBNP）暴露时心血管系统反应的模型为基础，对其心脏工作子模型中最大弹性系数（maximum elastance)乘以一个反映心肌收缩功能改变的系数。然后逐渐降低收缩功能改变系，仿真血容量减少12％后，心肌收缩功能降低0－305后LBNP时心率（HR）、血压（BP）和心输出量（CO）的变化。结果：心肌收缩功能降低将使LBNP时，HR加快，BP降低和CO减小。结论：心肌收缩功能降低导致心血管系统对立位应激的调节能力降低。