本文關鍵詞： 反復體 體位改變試驗 心血管調(diào)節(jié) 心血管參數(shù) 心血管反應 臥位 個體位 生理指標 心血管效應 自主神經(jīng)系統(tǒng) 　出處：《空軍醫(yī)學雜志》2016年06期 　論文類型：期刊論文

【摘要】：目的對同一組受試人群實施2種不同模式的反復體位改變刺激,通過比較試驗前、后及試驗中多項生理指標的變化,闡明2種反復體位改變對心血管影響的差異及應用方向。方法對12名健康男性進行不同模式的反復體位改變試驗,并在試驗前、后5min對受試者進行5min+75°的心血管反應測試(HUT)。以平臥位參數(shù)為對照,取受試者在每個體位第20、60s時的心率(HR)、血壓(SBP,DBP,MBP)、每搏量(SV)、心輸出量(CO)、總外周阻力(TPR)等指標進行分析。結(jié)果(1)HDT/HUT模式的試驗可使受試者在之后的HUT檢查時心血管反應指數(shù)(CRI)升高(P0.01),平臥位時的SV、CO顯著低于試驗前,TPR顯著升高;DBP、MBP、CO在HUT1min時較試驗前顯著下降,TPR顯著上升,SV在立位時有下降趨勢。SUP/HUT模式的試驗使之后的HUT檢查時平臥位的HR、CO下降,對CRI值、平臥位時的SV、TPR及立位時的BP沒有影響。(2)2種模式的反復體位改變試期間,多項心血管參數(shù)變化明顯,并呈現(xiàn)出規(guī)律性的變化。(3)在第4~8次體位改變期間,HDT/HUT模式HR的變化值顯著大于SUP/HUT模式的△HR。除前兩次體位改變之外,HDT/HUT模式的△BP小于SUP/HUT模式的△BP。除了第8次體位改變之外,在每個體位的20s,HDT/HUT模式的△SV、△CO都小于SUP/HUT模式的△SV、△CO。(4)將第1次體位改變與第10次體位改變時的各項指標比較發(fā)現(xiàn),HDT/HUT模式中,最后1次-15°60s時的SBP、MBP與第1次相比下降(P0.05),DBP有升高趨勢;第10次+50°20s時SBP、MBP與第1次相比下降(P0.05),DBP有升高趨勢;第10次+50°60s時SBP低于第1次時,DBP、MBP升高,但不具顯著性;第10次體位改變時TPR高于第1次,但不具顯著性。SUP/HUT模式中,除SBP在第10次0°60s時與第1次相比有下降趨勢外,SBP、DBP、MBP在其他時間點都升高,并且在正角度時有顯著性;第10次改變時TPR顯著高于第1次。結(jié)論(1)2種模式的反復體位改變試驗對心血管指標造成的影響具有一定的差異;(2)與HDT/HUT模式的反復體位試驗相比,機體能夠更好地適應SUP/HUT模式的反復體位改變試驗對心血管造成的影響;(3)自主神經(jīng)系統(tǒng)與外周血管因素共同參與反復體位改變試驗期間的心血管調(diào)節(jié)變化,外周血管因素可能是引起兩模式產(chǎn)生不同心血管效應的主要原因。
[Abstract]:Objective to compare the changes of multiple physiological indexes before, after and in the same group of subjects by repeated body position change stimulation of two different models in the same group of subjects. To elucidate the difference of cardiovascular effects of two repeated posture changes and their application directions. Methods 12 healthy men were tested with different models of repeated postural changes, and before the trial, The cardiovascular response of the subjects was measured at 75 擄for 5 min after 5 min. The parameters of supine position were used as control. The heart rate (HR), blood pressure (SBP), DBP (MBP), cardiac output (HUT) and total peripheral resistance (TPR) of the subjects at 2060 s in each position were analyzed. The results showed that the test of HDT / HUT model could enable the subjects to have a cardiovascular response index during the subsequent HUT examination. In supine position, SVCO in supine position was significantly lower than that before the test. The HUT1min level was significantly lower than that before the test. The SV increased significantly in the vertical position. The HUT / HUT model showed a decreasing trend. The HRCO in the supine position was decreased in the later HUT examination, and the level of HUT in the supine position was significantly decreased after the HUT examination in the supine position after the HUT examination, and the results showed that there was a significant decrease in the HUT level in the supine position after the HUT examination, and there was no significant difference between the two groups. There were no significant changes in multiple cardiovascular parameters during repeated postural changes in the two models, including CRI, supine position, and BP in orthostatic position, and no significant difference was found in the changes of cardiovascular parameters during the repeated postural changes of the two models, and there was no significant difference in the changes of cardiovascular parameters between the two models. The HR of HDT / HUT model was significantly higher than that of SUP/HUT model during the 4th postural change. The BP of HDT / HUT model was lower than that of SUP/HUT model except for the first two postural changes. In each position, SVCO in HDT / HUT mode was lower than that in SUP/HUT mode, CO. 4) the indexes of the first position change and the 10th position change were compared with each other in HDT / HUT mode. At the last one to 15 擄60s, the SBP of the SBP at the first time was higher than that of the first, and that at the 10th time at 50 擄20s was higher than that at the first time, and the SBP at the 10th time at 50 擄60s was lower than that at the first time, but there was no significant difference. TPR was higher at the 10th time than at the first time, but it was not significant in the model of .SUP / HUT, except for the decreasing trend of SBP at the 10th time (0 擄60s) compared with the first time (P < 0.01), and there was a significant increase in the SBP at the other time points, and there was a significant difference at the positive angle. The TPR at the 10th change was significantly higher than that at the first. Conclusion there is a certain difference in the effect of the repeated posture change test between the two models on cardiovascular indexes. (2) compared with the repeated posture test of the HDT/HUT model, there is a significant difference between the two models. The body can better adapt to the effect of repeated body position change test of SUP/HUT model on cardiovascular system) the autonomic nervous system and peripheral vascular factors are involved in the cardiovascular regulation during repeated posture change test. Peripheral vascular factors may be the main causes of different cardiovascular effects between the two models.
【作者單位】： 北京體育大學運動人體科學學院;中國航天員科研訓練中心;
【基金】：國家自然科學基金課題(81372126)
【分類號】：R85

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