运动负荷对青年学生和运动员心脏功能的影响

用无创法(阻抗法)测量了40名青年学生和40名运动员在两种运动负荷(50W和150W)运动前、运动后即刻和恢复时程的收缩时间间期(STI)和心率(HR)。在静态时,“运动员组”的心率较缓(P<0.01)、QS_1较长(P<0.05)、PEP/LVET比值较大(P<0.05和P<0.01)、LVETc较短(P<0.001)。运动后即刻,“学生组”和“运动员组”都表现为QS_z、LVET、PEP、IVCT、QS_1缩短、PEP/LVET比值减小、心率增速和LVETc延长。但“运动员组”QS_2、LYET的缩短和心率增速的程度较少,而PEP/LVET比值的减小和LVETc延长的程度较大。除PEP/LVET比值外,其余各项指标的恢复速度均与负荷量有关。“运动员组”的恢复速度较快,尤其在150W时更为明显。本文指出:1)用阻抗法测算动态下的STI更为实用;2)系统训练可提高心脏活动的潜力,改善泵功能,促进心脏活动的调节速度。     

急性心肌缺血对血液流变学和心脏收缩功能改变的影响

在麻醉开胸狗观察了急性心肌缺血对血液流变学和心脏收缩功能改变的影响。在阻断狗前降支冠脉1h内,血液流变学各参数发生异常变化,表现为高、低切变率下全血粘度(ηbh、ηb1)、血浆粘度、血细胞压积和纤维蛋白原升高,红细胞电泳时间缩短。同步描记心电、心音和颈动脉搏动图而记录的心脏收缩时间间期,表现为射血前期(PEP)延长、左室射血时间(LVET)缩短和PEP/LVET比值增大。此外,动脉舒张压(DAP)升高,心输出量(CO)减少。上述各参数均与对照值有明显差异,P<0.05。缺血40min时,对ηb1和PEP/LVET或DAP进行相关分析,呈明显正相关,P<0.05;ηb1和CO呈明显负相关,P<0.01。结果提示,心肌缺血后发生的血液流变学异常变化,具有增加射血阻力和减少心输出量的作用。     

测定心脏收缩时间间期在房间隔缺损中的应用

我们曾测量分析了房缺、室缺和动脉导管未闭患者中的心脏收缩时间间期(STI),发现心内分流和心外分流的心功变化有其不同的特点,其中房缺患者在STI上的变化是以PEP、ICT和Q-S_1延长,LVET缩短,PEP/LVET和ICT/LVET比值增大为特征的。本文在此基础上进一步分析了房缺患者中分流量、肺动脉压、年龄等与STI异常的关系,并比较手术前     

心脏收缩时间间期与冠状动脉狭窄程度或范围的相关性研究

心脏收缩时间间期(STI)通过单笔心电图机叠加记录ECG、心音图和颈动脉图后测得。对83例患者进行了STI均值与选择性冠状动脉造影(CAG)及左室造影的相关研究。患者除陈旧性心肌梗塞及室壁瘤外,根据冠状动脉(CA)狭窄程度而分组。STI随CA狭窄程度及范围的增加而显著异常,提示心功能随心肌缺血程度加重而进行性恶化。左室射血分数(LVEF)的降低也支持这一点。CA狭窄程度、范围与射血前时间/左室射血时间(PEP/LVET)呈正相关。在决定左室功能的异常方面,PEP/LVET和LVEF的临床意义完全相同。提示STI在评价冠心病心功能上是有用的。排除影响STI的某些因素后,PEP/LVET≥0.38可作为判断冠心病左心功能减退的标志。但轻度CA狭窄患者的STI可正常,这可能与静息时尚有足够的CA贮备力有关。     

肺动脉血流时间间期法评估肺动脉压

为评价肺动脉血流时间间期法评估肺动脉压的价值,本文观察了37例左向右分流先天性心脏病患者。在相同体位及取样容积位置下测量心室射血前期(PEP)、射血时间(ET)、加速时间(AT)、加速度(ACC)、F[F=PEP/(ATET)];计算肺动脉/主动脉血流时间间期比(FPA/FAO),并以各项比例系数与肱动脉压(BAP)的乘积作为肺动脉压的估测值。结果显示:肺动脉/主动脉血流时间间期比与右心导管估测的肺动脉收缩压(PASP)、平均压(PAMP)取得了较好的相关性(r分别为0.84、0.81);ACC次之(r分别为0.72、0.65);PEP/AT较差(r分别为0.53、0.50)。提示:肺动脉/主动脉血流时间间期比为无创定量评估肺动脉压的最佳方法。     

心阻抗血流图对儿童心功能的评价

目的：评价学龄前和学龄期儿童的心功能特点。方法：采用无创性心功能检测方法测定108例健康儿童和126例健康成年人的心脏功能。结果：SV、CO、PEP等九项指标随年龄的增长而增大,且三组间有差异（P〈0.0l）;CI、HI、C-dZ/dt、O-dZ/dt、Q-Z间期等五项指标在两儿童组间无差异（P〉0.05）,但在儿童与成人组间有差异（P〈0.0l）,EF、PEPI、LVETI、PEP/LVET、O/C等五项指标在三组间均无差异（P〉0.05）。结论：学龄前儿童的心功能指标有些与成年人差异很大,所以需要一套特殊指标作为参考,而不宜采用已有的成人标准值来判定儿童的心脏功能。     

蝮蛇抗栓酶治疗冠心病

应用蝮蛇抗栓酶治疗15例冠心病患者,其中12例为慢性冠心病患者,3例为急性心肌梗塞患者.治疗结果表明:治疗后心电图示心肌缺血改善者达72.7%,心脏 B 超示室壁运动改善者达80%,心阻抗血流图示 PEP/LVET 明显下降,P<0.01,CI 明显增高.P<0.05,说明蝮蛇抗栓酶具有明显的改善心肌缺血和左心室功能的作用。     

非侵入性超声测定狗的心输出量

本文介绍了应用二尖瓣和主动脉根部的回声图测定狗的心输出量,并用染料(伊文氏蓝)稀释法对照。每搏输出量按下列 Lalani公式计算:Q=V·α·LVET,V 为收缩期二尖瓣前叶回声图的关闭斜率,假设该斜率代表主动脉腔内血液的平均流速;α为主动脉根部的横截面积;LVET 为左室射血时间;Q 为每搏输出量。在8条狗的实验中,超声测定心输出量共13次,其中10次有染料稀释法对照。用超声法观察到狗的每搏输出量为9.1～24.7毫升,平均为14.2±5毫升,每分输出量为1662～3087毫升,平均为2258±414毫升。超声和染料稀释法所测得的每分输出量,两者密切相关(r=0.856,P<0.01,n=10)。心输出量是心功能的重要指标之一,非侵入性准确地测定心输出量,将给临床工作者监视患者心功能的变化,从而采取必要的临床措施提供方便,也给生理和药理工作者进一步研究心血管功能提供一个很重要的观察指标。1976年 Lalani 等在临床上应用超声记录二尖瓣和主动脉根部的回声图来推算心输出量,并用 Fick 直接法对照,获得两者的相关系数为0.9(n=34)。本实验试图利用这一超声方法对狗进行研究,用染料(伊文氏蓝)稀释法对照,计算两者的相关系数。     

海带磷酸烯醇式丙酮酸羧激酶的提取和特性(简报)

提取得到的海带PEP羧激酶粗酶比活性为1.21nmolNADH/mg蛋白·分。经硫酸铵分步沉淀和冻融过程后其比活性提高近4倍。抗氧化剂可提高PEPCK活性。该酶催化的羧化反应底物是PEP。ADP和Mn~(2+)是必需的辅助因子。酶反应的最适pH值是7.5。用部分纯化酶测得底物HCO_3~-的K_m值是14.0mmol/L,pEP是0.3mmol/L,ADP是0.1 mmol/L。     

体育锻炼对循环系统的影响(摘登)

青少年时期,正是人体各器官、系统生长发育的旺盛时期,如果坚持参加体育锻炼,对循环系统,特别是对心脏的机能有积极的促进作用。 1.降低安静时心率,提高心脏每次搏动的输出量经常进行锻炼的适应反应是降低安静和紧张应激时心肌的交感神经张力,增加迷走神经紧张度,以及心脏的窦房结对乙酰胆碱的敏感性提高,其表现是降低人体安静时心率和提高每搏输出量。如长期坚持锻炼者,在安静状态下,心脏每分钟只收缩40—50次便能满足全身对血液的需要量,而一般正常人每分钟心率是72次左右,据西德近年来报道,个别优秀运动员在安静时心率是每分钟29次。由于体育运动引起心脏扩大,心容量增加或由于心脏收缩能力增强而增加每搏输出量。 2.心脏形态学方面的变化锻炼可引起心脏产生工作性肥大,运动员由于肌肉经常活动,心脏的工作量增加,就会逐渐先引起张力性扩大,使心脏具有更大的收缩     

Calf blood flow and posture: Doppler ultrasound measurements during and after exercise.

To investigate the joint effects of body posture and calf muscle pump, the calf blood flow of eight healthy volunteers was measured with pulsed Doppler equipment during and after 3 min of rhythmic exercise on a calf ergometer in the supine, sitting, and standing postures. Muscle contractions seriously impeded calf blood flow. Consequently, blood flow occurred mainly between contractions and reached a plateau that lasted at least the final 100 s of each exercise series. After exercise the blood flow decreased much faster in the sitting and standing postures than in the supine posture. There was no difference in blood flow between various postures during the same submaximal exercise. However, subjects in the standing posture were able to perform exercise with a higher load than in the supine posture, and blood flow in the standing posture could become twice as high as in the supine posture. We conclude that calf blood flow is regulated according to needs; available perfusion pressure determined maximal blood flow and exercise; and compared with the supine posture, the standing posture and calf muscle pump increase the perfusion pressure.     

Systolic time intervals in burn injury

Systolic time intervals were studied in 28 young, previously healthy burn patients (TBS 10-90%) on 145 occasions. A NEK 116 type 3 channel recorder of 100 mm/sec paper speed was used. Synchronous ECG recordings in lead II, PCG in the m "1" frequency band, and external carotid pulse tracings were recorded. RR, QS2, S1S2, LVET, PEP, PEP/LVET and QT, QTc, QS2-QT intervals were measured in 5-10 cardiac cycles in each of the examinations. Calculation of the additional parameters ICT, LVET/ICT, DT, EVR, PRP, EF and SV values were correlated to the extent of, and the time elapsed since, burn injury. The derivated parameters and statistical analysis were performed on a Commodore 64 type computer based on a software program. Elongation of QTc (greater than 440 msec) and frequent electrodynamic failure (QT-QS2 greater than 40 msec) especially during the first postinjury week were found characteristic in severe injury. In 53% the PEP/LVET ratio was less than 0.31, mean 0.32 +/- 0.093. In 21 cases of severe hypovolaemia the increase of PEP raised this value beyond 0.41. With the exception of 3 examinations, QS2I was normal or shortened. Calculated EF were normal or increased, SV reduced being interdependent with burn extent and shortening of DT. In patients with severe burns, oxygenization was inadequate (EVR less than 0.8); it showed an inverse correlation to HR. The simultaneously high LVET/ICT ratio and shortened ICT values pointed to an increase in contractility.     

Polycardiographic evaluation of left ventricular function in the elderly]

Polycardiographic recordings have been carried out in 57 individuals (16 men and 41 women), aged between 70 and 97 years (mean age 78.3 years), both at rest and during the stimulation of circulatory system by the cooling of hand. Systolic time intervals of the left ventricle and QT/QS2 ratio have been evaluated. It was found, that systolic time intervals at rest did not differ significantly from those given by Weissler. Cooling of hand has been manifested by: prolongation of LVETI, decrease in PEP/LVET, prolongation of QS2I, and decrease in QT/QS2. Results suggest indirectly that myocardium of the elderly adapts to the stimulation through Frank-Sterling mechanism.     

Activity of respiratory muscles in upright and recumbent humans

It is established that during tidal breathing the rib cage expands more than the abdomen in the upright posture, whereas the reverse is usually true in the supine posture. To explore the reasons for this, we studied nine normal subjects in the supine, standing, and sitting postures, measuring thoracoabdominal movement with magnetometers and respiratory muscle activity via integrated electromyograms. In eight of the subjects, gastric and esophageal pressures and diaphragmatic electromyograms via esophageal electrodes were also measured. In the upright postures, there was generally more phasic and tonic activity in the scalene, sternocleidomastoid, and parasternal intercostal muscles. The diaphragm showed more phasic (but not more tonic) activity in the upright postures, and the abdominal oblique muscle showed more tonic (but not phasic) activity in the standing posture. Relative to the esophageal pressure change with inspiration, the inspiratory gastric pressure change was greater in the upright than in the supine posture. We conclude that the increased rib cage motion characteristic of the upright posture owes to a combination of increased activation of rib cage inspiratory muscles plus greater activation of the diaphragm that, together with a stiffened abdomen, acts to move the rib cage more effectively.     

Effects of posture on shear rates in human brachial and superficial femoral arteries

Shear rate is significantly lower in the superficial femoral compared with the brachial artery in the supine posture. The relative shear rates in these arteries of subjects in the upright posture (seated and/or standing) are unknown. The purpose of this investigation was to test the hypothesis that upright posture (seated and/or standing) would produce greater shear rates in the superficial femoral compared with the brachial artery. To test this hypothesis, Doppler ultrasound was used to measure mean blood velocity (MBV) and diameter in the brachial and superficial femoral arteries of 21 healthy subjects after being in the supine, seated, and standing postures for 10 min. MBV was significantly higher in the brachial compared with the superficial femoral artery during upright postures. Superficial femoral artery diameter was significantly larger than brachial artery diameter. However, posture had no significant effect on either brachial or superficial femoral artery diameter. The calculated shear rate was significantly greater in the brachial (73 +/- 5, 91 +/- 11, and 97 +/- 13 s(-1)) compared with the superficial femoral (53 +/- 4, 39 +/- 77, and 44 +/- 5 s(-1)) artery in the supine, seated, and standing postures, respectively. Contrary to our hypothesis, our current findings indicate that mean shear rate is lower in the superficial femoral compared with the brachial artery in the supine, seated, and standing postures. These findings of lower shear rates in the superficial femoral artery may be one mechanism for the higher propensity for atherosclerosis in the arteries of the leg than of the arm.     

Influence of high ambient temperatures on the physiological responses and body sway in healthy young adults after quickly standing

This study was aimed to compare the variations in cerebral oxygenation, blood pressure and center-of-foot pressure after standing from sitting and supine positions at normal (22 degrees C) and high (32 degrees C) room temperatures. Thirty young adults stood up from a resting posture (sitting or supine position) and kept the static standing posture for 90 sec. Meanwhile, their center-of-foot pressure (COP), blood pressure, and cerebral oxygenation kinetics were measured in continuity. The change of the frequency domain low-to-high frequency (LF/HF) ratio of the R-R interval before and after standing from a supine position was significantly higher than that from a sitting position under both temperature conditions. Blood pressure as well as total and oxygenated hemoglobin levels decreased immediately after standing up and the ratio of blood pressure change when moving from a supine position to standing at high room temperature was the largest as compared with the other conditions. Total hemoglobin (Hb) volume was found to temporarily decrease after standing and required 22-24 sec to recover when the subject started from the sitting position and 33-36 sec when the subject started from the supine position. Cerebral oxygenation kinetics tended to be larger under high, rather than normal, temperature conditions. All COP parameters after standing were significantly larger in the high temperature condition than in the normal temperature condition. Body sway after standing was larger in the high temperature condition than in the normal temperature condition and after standing from a supine position than from a sitting position. In conclusion, cerebral oxygenation kinetics and blood pressure measured after the subject moved to the standing position changed dramatically under high temperature conditions, and variations in this parameter may influence body sway.     

不同体位对严重肥胖者血氧饱和度的影响

目的:探讨不同体位对严重肥胖者血氧饱和度的影响。方法:16名平均体重指数(BMI)为40±5肥胖者和16名年龄匹配的正常体重者被纳入研究。分别在不同体外下(坐位、仰卧位、侧卧位)对所有参与者进行动脉血气监测。结果:肥胖者于坐位时动脉Pa O_2为75±4 mm Hg,Pa CO_2为37±3 mm Hg;仰卧位时动脉Pa O_2为62±5 mm Hg,Pa CO_2为47±5 mm Hg;侧卧位时Pa O_2为73±3 mm Hg,Pa CO_2为39±2 mm Hg;而正常体重者无明显变化。结论:严重肥胖者于平卧位时更容易出现低氧及高碳酸血症。     

350m氦氧模拟饱和潜水过程中潜水员坐位踏车时心缩间期的变化

在350m氦氧模拟饱和潜水过程中,对4名男性潜水员采用耳密度图导数图方法观察坐位踏车时心缩间期变化。在压力(300、230、135m)下和减压后的主要变化是等容收缩期、射血前期(PEP)和PEP/左室射血时间加大,与加压前比较有显著差异,尤其在踏车负荷加重时更为明显。提示心肌收缩力受高气压的影响而降低。     

Continuous monitoring of blood volume changes in humans

The mass density of antecubital venous blood was measured continuously for 80 min/session with 0.1 g/l precision at a flow rate of 1.5 ml/min in six male subjects. Each person participated in two different sessions with the same protocol. To induce transvascular fluid shifts, the subjects changed from sitting to standing and from standing to supine positions. There was transient blood density shifts immediately after postural changes, followed by an asymptotic approach to a new steady-state blood density level. Additional deviations from a simple time course were regularly observed. Blood density increased by 3.5 +/- 1.4 (SD) g/l when standing after sitting and decreased by 5.0 +/- 1.2 g/l while supine after standing. The corresponding half time of the blood density increase was 5.6 +/- 1.4 min (standing after sitting) and 6.9 +/- 3.1 min (supine after standing) of the blood density decrease. Erythrocyte density was calculated and did not change with body position. Whole-body blood density was calculated from plasma density, hematocrit, and erythrocyte density, assuming an F-cell ratio of 0.91. Volume shifts were computed from the density data; the subject's blood volume density decreased by 6.2 +/- 1.2% from sitting to standing and increased by 8.5 +/- 2.1% from standing to supine. Additional discrete plasma density and hematocrit measurements gave linear relations (P less than 0.001) between all possible combinations of blood density, plasma density, and hematocrit.(ABSTRACT TRUNCATED AT 250 WORDS)