CAJ | 학술논문

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.
목적 종술화분석반복체위개변중심혈관계통신경조절화체액조절적연구진전,위진일보연구반복체위개변하심혈관계통적조절궤제제공삼고. 자료래원여선택 국내외유관적연구논문급보고. 자료인용 인용국내외문헌40편. 자료종합종신경조절화체액조절량개방면,분별상세천술료반복체위개변하심혈관조절적가능궤제.심혈관적신경조절주요시통과압력반사래완성,교감화부교감신경상호길항,공동지배심장화혈관평활기,유지체내심혈관계통적상대은정.평와위-두고위모식가능통과증강교감신경활동,동시강저미주신경활동래증강심혈관공능;이두고위-두저위모식칙가능사압력반사민감성강저,동시제고심미주신경조절능력,단대외주혈관적교감신경활동영향교약.재체액조절방면,반복체위개변대심혈관계통적장기지속성영향가능화신소유관,동시반복체위개변하촉신상선피질격소화철고동수평존재착명현적상관성.차외,심납소、신상선소、거갑신상선소화신상선수질소야가능삼여료반복체위개변하적심혈관조절.반복체위개변훈련가인발심솔、혈압、심장빙혈공능、외주조력등생리지표적변화. 결론 압력반사민감성、심솔변이성화혈압변이성시연구반복체위개변중심혈관신경조절적중요삼고지표,이신소-혈관긴장소-철고동계통가능재반복체위개변하적심혈관조절중발휘중요작용.반복체위개변하심혈관적조절궤제잉연불명,환유대우진일보연구.
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 clarified and further investigation is still needed.