健康个体血液动力学系统对人工调节应激的适应反应

Y. Smolyakov, B. Kuznik, S. Kalashnikova, N. A. Nolfin, E. Fedorenko, M. M. Mikhahanov
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摘要

的目标。目的:研究人工应激对身体健康青年外周微循环血流动力学参数和心律变异性的影响。材料与方法。本研究共纳入30例患者,其中男性16例,平均年龄18.2±1.1岁。采用Stroop法建立人工应力。采用红细胞光的动态散射法对微循环血流动力学特性进行了评价。信号以三个血流动力学指标的形式进行整合:HI(血流动力学指标)。低频区(HI1)表征层间的缓慢相互作用,高频区(HI3)表征层间的快速剪切。HI2处于中间位置(毛细血管前和毛细血管血流)。从脉搏分量中分离出的心间隔变异性,通过变异性脉搏测量法(心率变异性,HRV)进行评估。结果。在研究过程中,在测试阶段观察到心率(HR)的增加,证实了高度的应激负荷。在血流动力学中,血流的重新分布被注意到向慢剪切速度(近壁血流)。停止应力负荷后,血流动力学参数下降并恢复到先前的值。表征节律变异性的参数- LF(交感神经成分)、HF(迷走神经活动)、CVI(非线性副交感神经指数)呈增长趋势;这里,LF/HF比值没有变化。结论。研究结果表明,有可能形成微循环参数变化和心律自主调节的多因素图景,特别是适应诱导应激的反应。所得剪切量的定量标准可整合为应力指标,用于临床实践。便携式mDLS传感器可以补充特定的评估标准,用于监测由压力情况引起的适应性反应,在临床实践中用于早期诊断和预后决策,以及用于患者的自我控制。
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Adaptation reactions of hemodynamic systems on artificially modulated stress in healthy individuals
Aim . To study the influence of artificially created stress on hemodynamic parameters  of peripheral microcirculation and variability of the heart rhythm in somatically healthy young individuals. Materials and Methods . In the study 30 individuals were involved (of them 16 men)  with the mean age 18.2±1.1 years. An artificial stress was created using Stroop method. Assessment of characteristics of hemodynamics of microcirculation (HM) was performed by the method of dynamic scattering of light from erythrocytes. The signal was integrated in the form of three hemodynamic indexes: HI ( Hemodynamic Indexes ). Low frequency index (HI1) was determined by a slow interlayer interaction, high frequency area (HI3) characterized fast shearing of layers. HI2 took intermediate position (precapillary and capillary blood flow). Variability of cardiointervals isolated from pulse component, was assessed by method of variation pulsometry ( Heart Rate Variability, HRV). Results . In the course of study, increase in the heart rate (HR) in the stage of testing was  observed that confirms a high extent of stress load. In hemodynamics, redistribution of blood  flow was noted toward slow shear velocities (near-wall blood flow). After cessation of stress load,  hemodynamic parameters declined and returned to previous values. Parameters characterizing variability of rhythm – LF (sympathetic component), HF (vagal activity), CVI (non-linear  parasympathetic index) showed a tendency to growth; here, LF/HF ratio did not change. Conclusion. In result of the carried out study it was possible to formulate a multifactor  picture of variation of parameters of microcirculation and of autonomic regulation of cardiac rhythm specific of reactions of adaptation to induced stress. The quantitative criteria of the  obtained shears may be integrated into stress indexes to be used in clinical practice. A portable mDLS sensor may be supplemented with specific assessment criteria and used for monitoring  of adaptive reactions induced by stressful situations, and for taking early diagnostic and prognostic decisions in the clinical practice, and for self-control of a patient.
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