高压氧预处理对加速度耐力不良飞行员心血管功能的影响  

Effect of hyperbaric oxygen preconditioning on cardiovascular function in pilots with poor acceleration endurance

作　　者：孙男男 黄杰[3] 徐庆[3] 朱姿英 晏沐阳[3] 刘红巾 SUN Nannan;HUANG Jie;XU Qing;ZHU Ziying;YAN Muyang;LIU Hongjin(Hebei North University,Zhangjiakou 075000,Hebei Province,China;Department of Identification,Air Force Medical Center,PLA,Beijing 100142,China;Department of Hyperbaric Oxygen,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]河北北方学院,河北张家口075000 [2]空军特色医学中心医学鉴定科,北京100142 [3]解放军总医院第一医学中心高压氧科,北京100853

出　　处：《解放军医学院学报》2023年第12期1330-1334,共5页Academic Journal of Chinese PLA Medical School

基　　金：军队课题(2021HKYX21)。

摘　　要：背景研究表明高压氧预处理(hyperbaric oxygen preconditioning,HBOP)能提高飞行员加速度耐力,其机制可能与改善自主神经功能有关,但相关研究甚少。目的探讨HBOP对加速度耐力不良飞行员下体负压(lower body negative pressure,LBNP)耐力的影响,并检测心脏量子谱(cardiac quantum spectrum,CQS;反映心肌功能)和反应性充血指数(reactive hyperemia index,RHI;反映血管内皮功能)等自主神经功能相关指标,探索HBOP改善加速度耐力的部分机制。方法选取2021年2-7月于空军特色医学中心鉴定为加速度耐力不良的飞行员为受试者,采用3次、多人高压氧(hyperbaric oxygen,HBO)舱暴露方案。吸氧共计95 min,每日1次(固定在14:30-16:05舱内吸氧),连续3 d。采用受试者自身前后对照设计,分别于HBOP前后测量其LBNP耐力、CQS和RHI。结果共20例飞行员被确定为加速度耐力不良。HBOP前受试者累积应激指数(cumulative stress index,CSI)为(-894.00±232.88)min·mmHg,HBOP后为(-1310.50±349.23)min·mmHg(t=6.546,P<0.001),提示LBNP耐力显著提高。HBOP前CQS指数为5.05±1.35,HBOP后为4.30±1.26,心肌功能指标显著改善(t=2.680,P=0.015)。HBOP前RHI值为1.46±0.43,HBOP后为1.78±0.54,血管内皮功能指标显著改善(t=-2.524,P=0.021)。结论HBOP能够提高加速度耐力不良飞行员的心肌功能和血管内皮功能,从而改善其LBNP耐力。Background It has been suggested that hyperbaric oxygen preconditioning(HBOP)can improve pilot acceleration endurance,and the mechanism may be related to improvement of autonomic function,but there are few researches on this.Objective To investigate the effect of HBOP on lower body negative pressure(LBNP)endurance in pilots with poor acceleration endurance,and detect autonomic function-related indexes such as cardiac quantum spectrum(CQS)and reactive hyperemia index(RHI),so as to explore the mechanisms by which HBOP improves acceleration endurance.Methods Pilots with poor acceleration tolerance at the Air Force Specialized Medical Center from February to July in 2021 were selected as subjects for a multi-person HBO chamber and a 3-times HBO exposure protocol.Oxygen inhalation was performed for a total of 95 min,once a day(fixed at 14:30-16:05 in the chamber),for 3 days.Using the subjects'own before-and-after control design method,their LBNP endurance,CQS and RHI were measured before and after HBOP.Results Twenty pilots were identified with poor acceleration tolerance.The cumulative stress index(CSI)was(-894.00±232.88)min·mmHg in subjects before HBOP and(-1310.50±349.23)min·mmHg in subjects after HBOP(t=6.546,P<0.001),which suggested that the LBNP endurance increased significantly.The CQS index was(5.05±1.35)before HBOP and(4.30±1.26)after HBOP,which indicated a significant improvement in myocardial function indexes(t=2.680,P=0.015).The RHI values were(1.46±0.43)before HBOP and(1.78±0.54)after HBOP,indicating a significant improvement in vascular endothelial function indexes(t=-2.524,P=0.021).Conclusion HBOP can improve myocardial function and vascular endothelial function in pilots with poor acceleration tolerance,thereby improving their LBNP tolerance.

关 键 词：高压氧 加速度耐力 飞行员 下体负压 心肌功能 血管内皮功能 

分 类 号：R852[医药卫生—航空、航天与航海医学]