卧床中及卧床后头高位倾斜对心率及血压变异谱的变化

观察了男性青年２１ｄ头低位６°卧床过程中以及卧床前、后７５°头高位倾斜（ＨＵＴ）时心率变异（ＨＲＶ）与动脉收缩压变异（ＳＢＰＶ）谱变化。卧床期间，完成者ＨＲＶ和ＳＢＰＶ谱的低，高频谱峰功率（ＬＦ和ＨＦ）均显著减小，ＨＲＶ谱低，高频谱峰功率比值（ＬＦ：ＨＦＨＲＶ）在卧床第１６ｄ有增大趋势，未完成者的相应谱指标有类似变化趋向，在卧床后ＨＵＴ初始６ｍｉｎ，所有被试者心率显著快于卧床前ＨＵＴ时相应值，而Ｌ     

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.     

Effects of acute exercise on attenuated vagal baroreflex function during bed rest.

We measured carotid baroreceptor-cardiac reflex responses in six healthy men, 24 h before and 24 h after a bout of leg exercise during 6 degrees head-down bed rest to determine if depressed vagal baroreflex function associated with exposure to microgravity environments could be reversed by a single exposure to acute intense exercise. Baroreflex responses were measured before bed rest and on day 7 of bed rest. An exercise bout consisting of dynamic and isometric actions of the quadriceps at graded speeds and resistances was performed on day 8 of bed rest and measurements of baroreflex response were repeated 24 h later. Vagally-mediated cardiac responses were provoked with ramped neck pressure-suction sequences comprising pressure elevations to +40 mm Hg, followed by serial, R-wave triggered 15 mm Hg reductions, to -65 mm Hg. Baroreceptor stimulus-cardiac response relationships were derived by plotting each R-R interval as a function of systolic pressure less the neck chamber pressure applied during the interval. Compared with pre-bed rest baseline measurements, 7 d of bed rest decreased the gain (maximum slope) of the baroreflex stimulus-response relationship by 16.8 +/- 3.4% (p < 0.05). On day 9 of bed rest, 24 h after exercise, the maximum slope of the baroreflex stimulus-response relationship was increased (p < 0.05) by 10.7 +/- 3.7% above pre-bed rest levels and 34.3 +/- 7.9% above bed rest day 7. Our data verify that vagally-mediated baroreflex function is depressed by exposure to simulated microgravity and demonstrate that this effect can be acutely reversed by exposure to a single bout of intense exercise.     

Cancellous bone structure of iliac crest biopsies following 370 days of head-down bed rest

INTRODUCTION: Static bone histomorphometry was applied to existing iliac bone sections originating from a 370-d 5 degrees head-down bed rest experiment. This bed rest experiment is the longest ever to have been conducted. We hypothesized that bed rest would decrease cancellous bone volume fraction and that this effect would be reversed by countermeasures. METHODS: Eight healthy male subjects underwent 370 d of 5 degrees head-down bed rest. Three subjects were treated with bisphosphonate (Xidifon, potassium salt of ethane-1-hydroxy-1-disphosphonate, EHDP) combined with an exercise regimen (1-2 h x d(-1)) for the entire study period. Five subjects underwent 120 d of bed rest without countermeasures followed by 250 d of bed rest with the exercise regimen. Transiliac bone biopsies were obtained either at baseline and day 366, or at baseline, day 116, and day 366 at alternating sides of the ileum. Static histomorphometry was performed using a computerized method. RESULTS: The 120 d of head-down bed rest without countermeasures resulted in decreased bone volume fraction BV/TV (-6.3%, p = 0.046) and trabecular number (Tb.N; -10.2%, p = 0.080) and increased trabecular separation (Tb.Sp; 14.7%, p = 0.020), whereas the 250 d of subsequent head-down bed rest with exercise treatment prevented further significant deterioration of the histomorphometric measures. DISCUSSION: The 120 d of 5 degrees head-down bed rest without countermeasures induced significant deterioration of iliac crest cancellous bone histomorphometric properties. On average, the countermeasures consisting of either bisphosphonate and exercise, or exercise alone were able to either prevent or stop immobilization-induced changes of the iliac cancellous bone structure.     

60d头低位卧床对人体膝关节软骨磁共振T_2值的影响

目的基于MRT2map技术研究60d模拟失重条件对人体膝关节软骨T2值的影响。方法7名健康男性头低位-6°卧床60d,应用1.5T磁共振扫描仪进行卧床前后膝关节矢状位多回波多层面序列扫描,使用profile软件测量实验前后膝关节非承重、承重软骨,髌软骨的T2弛豫时间,采用配对t检验比较实验前后软骨T2值改变。结果卧床实验前后软骨T2值具有相同的空间分布形态。60d模拟失重条件下胫骨内外侧髁承重软骨、股骨非承重软骨卧床后软骨深部T2值有降低趋势,近表面T2值有升高趋势,但是只在胫骨外侧髁承重软骨距骨软骨下骨质0.3处、胫骨内侧髁承重软骨距骨软骨下骨质0.0,0.1处、股骨非承重软骨距骨软骨下骨质0.0处T2值降低有统计学差异(P0.05);而胫骨内侧髁承重软骨距骨软骨下骨质0.4,0.5处T2值升高有统计学差异(P0.05)。其余各处软骨实验前后T2值未见统计学差异。结论-6°头低位卧床60d前后膝关节软骨T2值空间分布相似,胫骨内外髁承重软骨、股骨非承重软骨深部T2值发生改变,但总体来看头低位卧床对膝关节软骨T2特性影响较小。     

头低位卧床对眼内压、近视力、视野的影响及其中药防护

目的观察头低位卧床模拟失重对人体眼压、视野、近视力的影响 ,及中药对抗模拟失重的效果。方法 1 0名被试者随机分成对照组和中药组 ,用头低位 - 6° 2 1d卧床模拟失重 ,分别于卧床前、中、后测量两组被试者眼内压、近视力及视野。结果眼内压及近视力在卧床期间呈波动下降趋势 ,两者间存在一定相关性 ;中心视野变化无显著性 ;服中药可在一定程度上防止近视力下降。结论 1 )头低位卧床可引起眼压、近视力下降 ;2 )服中药可在一定程度上对抗模拟失重对近视力的不良影响     

Changes in body fluid compartments during a 28-day bed rest

The extravascular fluid responses to real or simulated space-flight are not well-documented. In this study serial isotope measurements were used to obtain measurements of the body fluid responses of 10 22-29-year-old men during 28 d of simulated microgravity (bed rest). The subjects were maintained on a controlled metabolic diet for 7 d before the study, during 14 d of ambulatory control, 28 d of horizontal bed rest, and 14 d of ambulant recovery. Fluid compartments were measured on control days 1 and 9, bed rest days 2, 14, and 28, and recovery days 7 and 14. By day 2 of bed rest, plasma volume (PV) and extra-cellular volume (ECV) decreased significantly by an average 209 and 533 ml, respectively. Red cell volume (RCV) and total body water (TBW) decreased more slowly, with average losses of 128 and 1,316 ml, respectively, after 28 d of bed rest. Early in the bed rest, TBW loss was mostly from the ECV. Thereafter, the TBW deficit was derived from the intracellular compartment, which decreased an average of 838 ml after 28 d. These results suggest losses from all fluid compartments during bed rest, with no evidence of restoration of ECV after 1-2 weeks.     

Effects of 1-week head-down tilt bed rest on bone formation and the calcium endocrine system.

To understand the potential early responses of human bone and the calcium endocrine system to spaceflight, we studied 8 healthy men, aged 35-44 years before, during, and after bed rest in a -6 degrees head-down tilt model for microgravity. Based on a novel single-dose labeling schedule, average rates of bone formation in the iliac crest were reduced in 6, unchanged in 1, and increased in 1 following the bed rest period. The decrease was greatest for subjects whose daily walking miles were highest (r = -0.762, p less than 0.05, n = 7). Before a measurable increase in ionized serum calcium the sixth bed rest day, there was increased excretion of urinary calcium and sodium, evident the first 2 bed-rest days and parallel for the entire week (r = 0.92, p less than 0.001). Reduced excretion of phosphorus and 3', 5' cyclic adenosine monophosphate on the first and second bed rest days was followed by an increase in serum phosphorus by the sixth bed rest day. Depressed serum concentrations of parathyroid hormone and 1,25-dihydroxyvitamin D were manifest by the sixth and seventh bed rest days. The similarity of the response of bone and the calcium endocrine system of healthy men after only 7 days to results of longer term bed rest studies emphasizes the responsiveness of the adult human skeleton to biomechanical stimuli induced by changes in activity and/or position.     

模拟失重不同时期热量摄入及血脂的变化

目的探讨模拟失重对机体膳食摄入营养状况和血脂含量的影响. 方法 18名被试者头低位-6°卧床21 d,用膳食称量法观察其营养素摄入量变化,记录卧床第1、11和21天的血脂含量. 结果三大热能基本满足生理需要,热量摄入在第2周降低,第3周后基本恢复正常;血脂无明显统计学变化. 结论模拟失重对机体膳食摄入营养状况有短期影响,经过适应期后可恢复到正常范围,血脂不受影响.     

Change in hemoglobin mass during prolonged hypokinesia]

The total hemoglobin mass was measured by the carbon monoxide method in 33 male test subjects, 21 of whom were exposed to 30-day bed rest and 6 of whom were exposed to 100-day bed rest. The hypokinetic test subjects showed a decrease in hemoglobin mass by 11-24%. During readaptation the test subjects who had a noticeable reduction of hemoglobin displayed a 2.7-fold increase of the reticulocyte count. It is suggested that the gravity decrease during bed rest and antiorthostatic hypokinesia results in a reduced rate of hemoglobin synthesis in bone marrow.     

Resistance training during unweighting maintains muscle size and function in human calf

PURPOSE: A 20-d 6 degrees head-down tilt bed rest project was conducted to evaluate the effect of dynamic leg press and plantar flexion resistance training on muscle size and function in human plantar flexors (PF) throughout the prolonged bed rest. METHODS: Twelve healthy men participated in this study and were divided two groups: resistance training (BR-Tr group: N = 6, age: 23 +/- 2 yr, height: 170 +/- 3 cm, weight: 66 +/- 7 kg) and nontraining (BR-Cont group: N = 6, age: 23 +/- 1 yr, height: 170 +/- 3 cm, weight: 67 +/- 6 kg) during the bed rest. Physiological cross-sectional area (PCSA) and peak torque of the PF muscle group was determined. Spin-spin relaxation times (T2) of the medial (MG) and lateral gastrocnemius (LG) and soleus (Sol) muscle was measured at rest and immediately after unilateral calf-raising exercise (5 sets of 10 reps). RESULTS: PCSA of the PF muscle group did not show any significant change in BR-Tr group; however, for the BR-Cont group, PCSA decreased by 13% after bed rest (P < 0.05). There was no significant change in exercise-induced T2 change of the MG, LG, or Sol muscles between before and after the bed rest in BR-Tr group; however, in the BR-Cont group, significant increases in T2 were found in these three muscles after the bed rest (P < 0.05 to 0.01). CONCLUSION: We conclude that dynamic leg press and plantar flexion resistance training during bed rest maintains muscle size and function (torque and T2), and that this training could be useful for prevention of progressive muscle deconditioning during spaceflight.     

Effects of resistance training during bed rest on the viscoelastic properties of tendon structures in the lower limb

The purpose of this study was to investigate the effects of resistance training on the tendon properties in knee extensors during 20 days of bed rest. Sixteen men were assigned to the resistance training group (BR-Tr) or the non-training, control group (BR-Con). Leg-press exercises were performed as five sets of 10 repetitions at 90% of maximum load daily for 20 days during bed rest. Before and after bed rest, the elongation of the tendon structures of the vastus lateralis muscle during isometric knee extension was determined using ultrasonography, while subjects performed ramp isometric contraction up to the voluntary maximum, followed by a ramp relaxation. The relationship between estimated muscle force ( F _m) and tendon elongation ( L ) was fitted to a linear regression curve, the slope of which was defined as stiffness. The hysteresis was calculated as the ratio of the area within the F _m– L loop to the area beneath the load portion of the curve. The stiffness decreased significantly after bed rest for BR-Con, but not for BR-Tr. Similarly, the hysteresis increased significantly after bed rest for BR-Con, but not for BR-Tr. These results suggested that the bed rest caused the stiffness of tendon structures to decrease and their hysteresis to increase, and that leg-press training prevents the deconditioning of the tendon structures in knee extensors.     

Effects of 20 days of bed rest on the viscoelastic properties of tendon structures in lower limb muscles

Objectives: The purpose of this study was to investigate the effects of 20 days' bed rest on the viscoelastic properties of human tendon structures in knee extensor and plantar flexor muscles in vivo.

Methods: Eight healthy men (age: 24±4 years, height: 172±9 m, body mass: 69±13 kg) carried out a 6° head-down bed rest for 20 days. Before and after bed rest, elongation (L) of the tendon and aponeurosis of vastus lateralis (VL) and medial gastrocnemius muscles (MG) during isometric knee extension and plantar flexion, respectively, were determined using real-time ultrasonic apparatus, while the subjects performed ramp isometric contraction up to the voluntary maximum, followed by ramp relaxation. The relationship between estimated muscle force (Fm) and tendon elongation (L) was fitted to a linear regression, the slope of which was defined as stiffness. The hysteresis was calculated as the ratio of the area within the Fm-L loop to the area beneath the load portion of the curve.

Results: L values above 100 N were significantly greater after bed rest for VL, while there were no significant differences in L values between before and after for MG. The stiffness decreased after bed rest for VL (70.3±27.4 v 50.1±24.8 N/mm, before and after bed rest, respectively; p = 0.003) and MG (29.4±7.5 v 25.6±7.8 N/mm, before and after bed rest, respectively; p = 0.054). In addition, hysteresis increased after bed rest for VL (16.5±7.1% v 28.2±12.9%, before and after bed rest, respectively; p = 0.017), but not for MG (17.4±4.4% v 17.7±6.1%, before and after bed rest, respectively; p = 0.925).

Conclusions: These results suggested that bed rest decreased the stiffness of human tendon structures and increased their hysteresis, and that these changes were found in knee extensors, but not the plantar flexors.

     

卧床模拟失重状态的中医辨证初探

用中医辨证法对１５名卧床２１ｄ的受试者民出现的临床证象发生发展进行了辨证分型。结果表明：卧床２１ｄ出现了肾阴虚、阴虚阳亢、脾气虚、血瘀四种证型，其中卧床３ｄ时各证象都较重，随卧床时间延长肾阴虚、阴虚阳亢逐渐减轻，脾气虚、血瘀变化同３displaystatus     

Intracranial pressure dynamics assessed by noninvasive ultrasound during 30 days of bed rest

INTRODUCTION: Intracranial pressure (ICP) may be an important contributor to symptoms of space adaptation syndrome during the initial days of microgravity exposure. The temporary nature of these symptoms suggests that some physiologic adaptation or compensation occurs. Fluid shifts similar to those in microgravity can be simulated on Earth using head-down tilt (HDT) bed rest. This study was performed to calibrate a new noninvasive ICP instrument and to investigate ICP adaptation during 30 d of HDT bed rest. METHODS: A noninvasive ultrasound technique that measures small skull expansions with fluctuations in ICP was used to measure cranial oscillations before and near the end of 30-d HDT bed rest in eight healthy, male volunteers. Pulse phase-locked loop (PPLL) output voltage and arterial BP were continuously monitored and correlated. RESULTS: The amplitude of intracranial distance pulsation decreased during 30-d bed rest. Prior to bed rest, the PPLL amplitude was 25 +/- 9 mV and this amplitude was reduced by 60% to 9 +/- 4 mV (a value consistent with that of upright posture) at the end of HDT bed rest (p = 0.01). DISCUSSION: PPLL measurements of skull pulsations are acutely posture dependent, being significantly higher in supine and HDT as compared with upright posture. A cephalad fluid shift is probably the responsible mechanism. Our results indicate that there are adaptations to intracranial pooling of blood and tissue fluid during bed rest that reduce skull pulsation amplitudes to values similar to those obtained in normal upright posture. Detailed studies of the time course of cranial vessel and bone adaptations may provide insights into the potential adaptative mechanisms.     

Effect of hypoxia on water-electrolyte metabolism and human renal function with different degrees of motor activity]

It was demonstrated that a prolonged (24 days) bed rest at altitudes of 2200 m and 3200 m as well as at sea level was accompanied by an increased renal excretion of fluids and osmotically active substances, including electrolytes. Exercises done during bed rest indiced a smaller increase of the renal excretion of sodium and potassium. However, as bed rest continued the differences between the groups of test subjects disappeared. The levels of hypoxia and exercises used in the study proved inefficient to prevent changes in the fluid-electrolyte metabolism occurring during bed rest.     

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。     

Central blood circulation in the healthy human being during 7 days' head-down tilt hypokinesia

The effect of 7-day head-down tilt (-15 degrees) and lower body negative pressure on circulation and oxidative metabolism was investigated on 13 healthy male test subjects. For 7-10 days they had Swan-Ganz catheters implanted in the pulmonary artery and a special cannula in the radial artery. The most marked changes were seen in the pulmonary artery pressure (PAP) and central venous pressure (CVP) that varied in a phase-like manner. By the 7th hour of bed rest the PAP increased significantly; this was followed by increases in the total lung resistance and the right ventricle function, as well as by a slight decrease of renin and aldosterone. Beginning with bed rest days 2 or 3 the PAP and CVP declined and remained lowered, as compared to the pretest level, till the end of bed rest. The responses to LBNP tests changed by bed rest day 2. Possible mechanisms of the above changes at rest and during LBNP tests are discussed.     

Effect of prolonged bed rest on the anterior hip muscles

Prolonged bed rest and inactivity is known to cause muscular atrophy with previous research indicating that muscles involved in joint stabilisation are more susceptible. The anterior hip muscles are important for hip joint function and stability but little is known about the effects of prolonged inactivity on their function. This study investigated the effect of prolonged bed rest on the size of the anterior hip muscles and their pattern of recovery. The effect of resistive vibration exercise (RVE) as a countermeasure to muscle atrophy was also investigated. 12 male participants, randomly assigned to either a control or an exercise group, underwent 8 weeks of bed rest with 6 months follow-up. Changes in muscle cross-sectional area (CSA) of the iliacus, psoas, iliopsoas, sartorius and rectus femoris muscles were measured by magnetic resonance imaging at regular intervals during bed rest and recovery phases. CSAs of iliopsoas and sartorius decreased at the hip joint (p < 0.05) during bed rest but iliacus, psoas, and rectus femoris CSAs were unchanged (p > 0.05). No significant difference was found between the two groups for all muscles (all p > 0.1), suggesting inefficacy of the countermeasure in this sample. These findings suggest that prolonged bed rest can result in the atrophy of specific muscles across the hip joint which may affect its stability and function.     

Plasma viscosity elevations with simulated weightlessness

Bed rest studies which simulate weightlessness have demonstrated marked changes in the state of hydration of subjects as well as decrements in aerobic capacity. These two phenomena may be linked through increases in blood viscosity which is altered by a loss of free water and which, in turn, influences blood flow needed for aerobic muscular work. This study examines changes in the rheologic properties of blood which attend changes in plasma volume with bed rest in humans and correlates these changes with alterations in aerobic capacity. Eight healthy human subjects were studied on the 6th day of bed rest during two consecutive 10-d bed rest periods separated by a 14-d recovery interval designed to simulate the flight-layover schedule of shuttle astronauts. Plasma viscosity was measured with a Wells-Brookfield viscometer, plasma volume by dye dilution, and maximal aerobic capacity (VO2max) by recumbent cycle ergometry. Bed rest resulted in significant increases in hematocrit and in total plasma protein concentration and fibrinogen concentration, both of which contribute to an elevation in plasma viscosity. The greater than 20% increase in fibrinogen concentration was much greater than could be explained by hemoconcentration. VO2max decreased significantly in the first but not the second bed rest cycle. In many individuals, a decrease in plasma volume and aerobic capacity was coupled with elevated plasma viscosity and hematocrit; however, significant correlations between these variables were lacking. Although significant rheologic perturbations do occur with bed rest, in this study, blood viscosity elevation failed to directly correlate with the reduction in VO2max.(ABSTRACT TRUNCATED AT 250 WORDS)