CAJ | 학술논문

目的比较不同体位下进行Valsalva动作时，心血管响应型式的差别. 方法在-15°头低位倾斜、水平仰卧和+75°头高位倾斜三种体位下，分别进行4 kPa /30s的Valsalva动作，并记录逐跳心率及动脉血压变化. 结果 +75°头高位倾斜体位下，心率在Ⅱ相的增高幅度最大；在Ⅲ相时呈降低变化，而在另外两种体位下则呈升高变化. 血压在Ⅱ相前期的降低幅度以在-15°头低位倾斜体位下为最小，在+75°头高位倾斜体位下为最大. +75°头高位倾斜体位下血压在Ⅲ相呈升高反应，而在-15°头低位倾斜和水平仰卧体位下血压呈典型降低变化. 体位改变对Valsalva动作II相心率、血压响应模式的影响最大. 结论体位改变可引起中心血量重新分配及自主神经均衡性改变，故对Valsalva动作时心率和血压的响应模式产生影响.
목적비교불동체위하진행Valsalva동작시，심혈관향응형식적차별. 방법재-15°두저위경사、수평앙와화+75°두고위경사삼충체위하，분별진행4 kPa /30s적Valsalva동작，병기록축도심솔급동맥혈압변화. 결과 +75°두고위경사체위하，심솔재Ⅱ상적증고폭도최대；재Ⅲ상시정강저변화，이재령외량충체위하칙정승고변화. 혈압재Ⅱ상전기적강저폭도이재-15°두저위경사체위하위최소，재+75°두고위경사체위하위최대. +75°두고위경사체위하혈압재Ⅲ상정승고반응，이재-15°두저위경사화수평앙와체위하혈압정전형강저변화. 체위개변대Valsalva동작II상심솔、혈압향응모식적영향최대. 결론체위개변가인기중심혈량중신분배급자주신경균형성개변，고대Valsalva동작시심솔화혈압적향응모식산생영향.
AIM　To examine the influence of posture shift on the pattern of heart rate and blood pressure response to Valsalva. METHODS　Thirty seconds Valsalva maneuver strains at 4 kPa were performed under -15° head-down tilt, supine or +75° head-up tilt posture, and the beat-by-beat changes of heart rate and blood pressure were noninvasively recorded and analyzed. RESULTS　The increasing change of heart rate for phase Ⅱ under +75° head-up tilt was beyond that under the other two postures. Under +75° head-up tilt, the heart rate decreased during phase Ⅲ, whereas under horizontal supine or -15° head-down tilt posture, the heat rate manifested an increasing change. The decreasing change of blood pressure during early phase Ⅱ was lowest under -15° head-down tilt, and highest under +75° head-up tilt. Blood pressure increased during phase Ⅲ under +75° head-up tilt, and decreased under other two postures. CONCLUSION　Posture shift alters the response pattern of heart rate and blood pressure during Valsalva maneuver, by circulating blood volume redistribution and autonomic balance shift to sympathetic predomination.