Physiological stress markers during breath-hold diving and SCUBA diving
Physiological stress markers during breath-hold diving and SCUBA diving
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DOI：
10.14814/phy2.14033
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发表时间：
2019-03-01
影响因子：
2.5
通讯作者：
Joulia, Fabrice C.
中科院分区：
文献类型：
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作者：
Marlinge, Marion;Coulange, Mathieu;Joulia, Fabrice C.
本研究通过比较SCUBA潜水（压力源：静水压力、寒冷和高氧）、呼吸暂停潜水（静水压力、寒冷、体力活动、缺氧）和干燥静态呼吸暂停（仅缺氧），调查了潜水中生理压力的来源。我们假设，尽管长时间的静态呼吸暂停会导致缺氧，但它比SCUBA潜水或呼吸暂停潜水的压力要小，因为后者结合了高压，体力活动和寒冷暴露。对12名潜水员和12名呼吸暂停潜水员在潜水前后进行了血液采样。在不同的情况下，样本收集从窒息组之前和之后的最大静态干燥呼吸暂停。我们测量了每种情况下应激激素皮质醇和和肽素水平的变化。为了确定应激的局部效应，我们测量了心脏损伤标志物肌钙蛋白（cTnI）和脑钠肽（BNP）、肌肉应激标志物肌红蛋白和乳酸盐以及低氧血症标志物缺血修饰白蛋白（IMA）的水平。和肽素，皮质醇，IMA水平增加的呼吸暂停潜水和静态干燥呼吸暂停，而他们下降的水肺潜水。肌钙蛋白，脑钠肽，肌红蛋白水平增加的呼吸暂停潜水，但没有变化的水肺潜水和静态干燥呼吸暂停。我们的结论是，缺氧引起的呼吸暂停是主要的触发释放应激激素和心脏损伤标志物，而寒冷或高压暴露发挥次要作用。这些结果表明，受试者在进行重大的呼吸暂停操作之前，应仔细筛查既存心脏疾病。
This study investigated the sources of physiological stress in diving by comparing SCUBA dives (stressors: hydrostatic pressure, cold, and hyperoxia), apneic dives (hydrostatic pressure, cold, physical activity, hypoxia), and dry static apnea (hypoxia only). We hypothesized that despite the hypoxia induces by a long static apnea, it would be less stressful than SCUBA dive or apneic dives since the latter combined high pressure, physical activity, and cold exposure. Blood samples were collected from 12SCUBA and 12 apnea divers before and after dives. On a different occasion, samples were collected from the apneic group before and after a maximal static dry apnea. We measured changes in levels of the stress hormones cortisol and copeptin in each situation. To identify localized effects of the stress, we measured levels of the cardiac injury markers troponin (cTnI) and brain natriuretic peptide (BNP), the muscular stress markers myoglobin and lactate), and the hypoxemia marker ischemia-modified albumin (IMA). Copeptin, cortisol, and IMA levels increased for the apneic dive and the static dry apnea, whereas they decreased for the SCUBA dive. Troponin, BNP, and myoglobin levels increased for the apneic dive, but were unchanged for the SCUBA dive and the static dry apnea. We conclude that hypoxia induced by apnea is the dominant trigger for the release of stress hormones and cardiac injury markers, whereas cold or and hyperbaric exposures play a minor role. These results indicate that subjects should be screened carefully for pre-existing cardiac diseases before undertaking significant apneic maneuvers.