呼吸频率调节下切断家兔迷走神经对心率变异和血压即时变异影响的研究  

Influence of rabbit vagus nerves cutting on heart rate variability and blood pressure instant variability under respiratory rate regulation

作　　者：沈仲元[1] 竺英祺[1] 闫世彪[2] Shin Lin 

机构地区：[1]上海中医药大学气功研究所,上海200030 [2]辽宁医学院附属第一医院心血管研究所,辽宁锦州121001 [3]加州大学尔湾分校生物物理研究中心,美国加利福尼亚92697

出　　处：《实用心电学杂志》2017年第2期77-83,共7页Journal of Practical Electrocardiology

基　　金：国家自然科学基金资助项目(81072853)

摘　　要：目的在呼吸频率调节下,观察家兔切断双侧迷走神经前后、呼吸停止前后的心率变异(heart rate variability,HRV)、血压即时变异(blood pressure instant variability,BPIV)与呼吸的关系。方法选取10只标准实验家兔,建立兔机械通气模型,在麻醉下施行呼吸机机械通气,潮气量恒定10 mL/kg,呼吸频率70次/min。切断双侧迷走神经前后和呼吸停止前后连续记录心电、呼吸和血压;分析呼吸频率变化与HRV、BPIV变化的关系。结果在切断双侧迷走神经前,R-R间期、BP-BP与呼吸相呈同步周期性变化,趋势一致,HRV及BPIV的中心频率均与呼吸功率谱密度中心频率一致。在切断双侧迷走神经后,R-R间期、BP-BP与呼吸同步周期性变化和趋势一致性被破坏,HRV及BPIV的中心频率基本消失,与呼吸功率谱密度中心频率不一致;呼吸停止后HRV及BPIV消失。结论呼吸调节下的HRV、BPIV符合呼吸性窦性心律不齐的生理机制,是R-R间期变化的二次效应,反映了自主神经平衡调节的结果,符合肺牵引受体兴奋所引起的Hering-Breuer反射的机制。Objective To observe the relationship between blood pressure instant variability( BPIV),heart rate variability( HRV) and respiration in rabbits separately before and after hibateral vagus nerves cutting and respiratory arrest under respiratory rate regulation. Methods Ten standard experiment rabbits were selected and rabbit model of mechanical ventilation was established. The rabbits were conducted with mechanical ventilation under anesthesia by ventilator,with a constant tide volume of 10 mL/kg and respiratory rate of 70 times/min. Continuous recording of ECG,respiration and blood pressure was performed separately before and after hibateral vagus nerves cutting and respiratory arrest. The relationship between changes of HRV,BPIV and respiratory rate was analyzed. Results Before cutting hibateral vagus nerves,R-R interval and BP-BP were synchronizedwith the respiratory phase,with the same trend. The central frequencies of HRV and BPIV were both consistent with the central frequency of respiratory power spectral density. After cutting hibateral vagus nerves,the synchronous periodic change and trend consistency of R-R interval,BP-BP and respiration was destroyed; the central frequency of HRV and BPIV almost disappeared and was inconsistent with the central frequency of respiratory power spectral density; HRV and BPIV disappeared after respiratory arrest. Conclusion The changes of HRV and BPIV under respiratory rate regulation accord with the physiological mechanism of respiratory sinus arrhythmia. It is the secondary effect of R-R interval change which reflects the result of balance adjustment of autonomic nerve.It also coincides with the mechanism of Hering-Breuer reflex induced by excitation of the tow receptor in the lung.

关 键 词：呼吸调节 随意性呼吸 切断迷走神经 血压即时变异 心率变异 

分 类 号：R542.2[医药卫生—心血管疾病]