稳态姿势变化对人体脑血管顺应性没有影响。

Alicia M Kells, M Erin Moir, Geoff B Coombs, Andrew W D'Souza, Stephen A Klassen, Baraa K Al-Khazraji, J Kevin Shoemaker
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Mean arterial pressure (MAP) increased from supine to seated (76(9) vs. 81(12) mmHg; <i>P</i> = 0.006) and from supine to standing (76(9) vs. 82(13) mmHg; <i>P</i> = 0.034). Mean blood flow was greater in the MCA relative to the forearm (forearm: 40(5) mL·min<sup>-1</sup>, MCA: 224(17) mL·min<sup>-1</sup>; main effect <i>P</i> < 0.001). Conversely, vascular resistance (forearm: 3.25(0.50) mmHg<sup>-1</sup>·mL·min<sup>-1</sup>, brain: 0.36(0.04) mmHg<sup>-1</sup>·mL·min<sup>-1</sup>; main effect <i>P</i> < 0.001) and compliance (forearm: 0.010(0.001) mL·min<sup>-1</sup>·mmHg<sup>-1</sup>, brain: 0.005(0.001) mL·min<sup>-1</sup>·mmHg<sup>-1</sup>; main effect <i>P</i> = 0.001) were greater in the forearm compared to the brain. Significant main effects of posture were observed with decreasing values in upright positions for mean blood flow (<i>P</i> = 0.001) in both vascular beds, but not for resistance (<i>P</i> = 0.163) or compliance (<i>P</i> = 0.385). 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摘要

本研究旨在确定姿势变化对颅内(脑部)与颅外血管床(前臂)血管顺应性的影响。18 名年轻人(9 名女性)进行了从仰卧到坐立再到站立的训练,每个姿势休息 5 分钟。在每个姿势下连续记录血压、大脑中动脉(MCA)血流速度和肱动脉血流速度。在每个姿势下连续进行三到五个稳态心脏循环,通过四要素凑合参数修正 Windkessel 模型进行分析,以计算血管顺应性。从仰卧到坐位(76[9] vs 81[12] mmHg;P=0.006)以及从仰卧到站立(76[9] vs 82[13] mmHg;P=0.034),平均动脉压(MAP)均有所增加。相对于前臂,MCA 的平均血流量更大(前臂:40[5] ml-min-1,MCA:224[17] ml-min-1;主效应 P=0.006)。
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No influence of steady-state postural changes on cerebrovascular compliance in humans.

The aim of this study was to determine the effect of posture changes on vascular compliance in intracranial (brain) versus extracranial vascular beds (forearm). Eighteen young adults (nine females) performed a supine-to-seated-to-standing protocol involving 5 min of rest in each position. Continuous blood pressure, middle cerebral artery (MCA) blood velocity, and brachial artery blood velocity were recorded at each posture. Three to five consecutive steady-state cardiac cycles at each posture were analyzed by a four-element lumped parameter modified Windkessel model to calculate vascular compliance. Mean arterial pressure (MAP) increased from supine to seated (76(9) vs. 81(12) mmHg; P = 0.006) and from supine to standing (76(9) vs. 82(13) mmHg; P = 0.034). Mean blood flow was greater in the MCA relative to the forearm (forearm: 40(5) mL·min-1, MCA: 224(17) mL·min-1; main effect P < 0.001). Conversely, vascular resistance (forearm: 3.25(0.50) mmHg-1·mL·min-1, brain: 0.36(0.04) mmHg-1·mL·min-1; main effect P < 0.001) and compliance (forearm: 0.010(0.001) mL·min-1·mmHg-1, brain: 0.005(0.001) mL·min-1·mmHg-1; main effect P = 0.001) were greater in the forearm compared to the brain. Significant main effects of posture were observed with decreasing values in upright positions for mean blood flow (P = 0.001) in both vascular beds, but not for resistance (P = 0.163) or compliance (P = 0.385). There were no significant interaction effects between vascular bed and posture for mean flow (P = 0.057), resistance (P = 0.258), or compliance (P = 0.329). This study provides evidence that under steady-state conditions, posture does not affect cerebrovascular compliance.

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