反复体位改变中心血管调节的神经和体液机制  

Neural and humoral mechanisms of cardiovascular regulation during repeated body position change

作　　者：李赢[1] 刘敏[2] 吴萍[2] 周越[1] 吴斌[2] 

机构地区：[1]北京体育大学运动人体科学学院,100084 [2]中国航天员科研训练中心,北京100094

出　　处：《中华航空航天医学杂志》2015年第3期234-238,共5页Chinese Journal of Aerospace Medicine

基　　金：国家自然科学基金（81372126）;总装试验技术课题（2013SY54B0201、2014SY54A0001）

摘　　要：目的 综述和分析反复体位改变中心血管系统神经调节和体液调节的研究进展,为进一步研究反复体位改变下心血管系统的调节机制提供参考. 资料来源与选择 国内外有关的研究论文及报告. 资料引用 引用国内外文献40篇. 资料综合从神经调节和体液调节两个方面,分别详细阐述了反复体位改变下心血管调节的可能机制.心血管的神经调节主要是通过压力反射来完成,交感和副交感神经相互拮抗,共同支配心脏和血管平滑肌,维持体内心血管系统的相对稳定.平卧位-头高位模式可能通过增强交感神经活动,同时降低迷走神经活动来增强心血管功能;而头高位-头低位模式则可能使压力反射敏感性降低,同时提高心迷走神经调节能力,但对外周血管的交感神经活动影响较弱.在体液调节方面,反复体位改变对心血管系统的长期持续性影响可能和肾素有关,同时反复体位改变下促肾上腺皮质激素和醛固酮水平存在着明显的相关性.此外,心钠素、肾上腺素、去甲肾上腺素和肾上腺髓质素也可能参与了反复体位改变下的心血管调节.反复体位改变训练可引发心率、血压、心脏泵血功能、外周阻力等生理指标的变化. 结论 压力反射敏感性、心率变异性和血压变异性是研究反复体位改变中心血管神经调节的重要参考指标,而肾素-血管紧张素-醛固酮系统可能在反复体位改变下的心血管调节中发挥重要作用.反复体位改变下心血管的调节机制仍然不明,还有待于进一步研究.Objective To review the progress on the neural and humoral regulation of cardiovascular system under the repeated body position change for further research reference.Literature resource and selection Research papers and study reports in this field.Literature quotation Forty references were cited.Literature synthesis The cardiovascular regulation mechanisms was described in 2 aspects：①The neural regulation of cardiovascular system during repeated position change.The neural regulation is predominantly done by baroreflex.Sympathetic and parasympathetic nerve act on heart and vascular smooth muscle with antistatic function to maintain the stability of the cardiovascular system.The supine-head up tilt mode may reduce vagus nerve sensitivity and increase the regulation of sympathetic nervous.The head up and down tilt mode,however,may decrease baroreflex sensitivity,and improve the function of heart vagus nerve regulation as well,but it influences less on perivascular sympathetic nervous activity.② The humoral regulation of cardiovascular system during repeated position change.The longer-lasting endocrine effects of repeated body position change may be the result of aldosterone.And there is significant correlation between the level of Adrenocorticotropic hormone and aldosterone.Furthermore,atrial natriuretic peptide,epinephrine,nonepinephrine and adrenomedulin may also play roles in cardiovascular regulation during repeated body position change.The repeated body position change causes the physiological changes on heart rate,blood pressure,cardiac function,peripheral resistance and so on.Conclusions Baroreflex sensitivity,heart rate variability and blood pressure variability are the important reference indexes of investigating the neural regulation during repeated body position change,and renin-angiotensinaldosterone system may play a crucial role on the regulation of cardiovascular function during the procedure.Above all,the mechanisms of cardiovascular regulation during repeated body position change are not fully

关 键 词：体位 心血管生理学 重力改变 神经调节 体液转移 

分 类 号：R852.21[医药卫生—航空、航天与航海医学]