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。

Changes of Tolerance and Cardiovascular Responses to Head-up Tilte Combined with LBNP Following Preceding Exposure to Head-down Tilt

Objective To observe pre-syncopal limited tolerance and cardiovascular responses to head-up tilt combined with lower body negative pressure (HUT/LBNP) following exposure to head-down tilt (HDT, -1 Gz). Method Exposures to HUT/LBNP (-60 mmHg) in control session (without preceding 30 s -1 Gz treatment) and in simulated push-pull effect (PPE) session (with preceding 30 s -1 Gz treatment) were performed in 8 healthy adults. The changes of hemodynamic parameters were monitored by electrical impedance instrument during the experiments. Result The mean endurance time in presyncopal symptom limited HUT/LBNP in control session and in simulated PPE session were 8.4±2.1 min and 4.5±2.4 min, respectively, the two means were significantly different (P< 0.01). In simulated PPE session, as compared with baseline, heart rate (HR) during HDT was significantly lowered (P<0.01), while stroke volume (SV) and cardiac output (CO) were increased significantly (P<0.01). During HUT/LBNP, the increased percentage (relative to baseline) of HR in PPE session was lower than these in control session (P<0.05); the decreased percentages of SV and CO during HUT/LBNP in PPE session were both higher than those in control session (P<0.05). During HUT/LBNP, arterial pulse pressure (PP) of control session was significantly decreased than the value of baseline value (P<0.05); Total peripheral resistance (TPR) of PPE session was significantly increased than baseline value (P<0.05). Conclusion Tolerance time before the appearance of presyncopal symptoms during HUT/LBNP decreases and cardiovascular responses to HUT/LBNP are impaired, preceding exposure to HDT.