重力是体位改变过程中最基本的生物力学刺激因素.血流压力是表征心血管功能状态的一个基本指标.目前,体位改变影响心血管系统的确切内部机制尚不清楚.为此,采用在流体和固体方程中分别引入体力项的方法,建立一个基于血流动力学概念的三维流固耦合数学模型,用以研究体位改变,确切量化重力对血流压力的影响.通过数值计算,得到以下结果.水平卧位条件下:a.单一血管中血流压力由无重力影响的轴对称二维分布变为重力影响下的三维不对称分布;b.随着进出口压差由小变大,重力对压力分布和极值的影响由大变小,当压差值分别达到10 665.6 Pa(80 mmHg)和2 666.4 Pa(20 mmHg)时,重力的影响就不再随进出口压差增大而变化;对三维单一流体,重力影响的总体趋势类似.对正、倒直立位,压力均为二维轴对称分布,其重力影响强度约为水平卧位的2倍以上.结果表明:基于血流动力学概念,引入体力项,建立三维流固耦合模型为研究体位改变提供了一种新思路,重力对单一血管中血流压力分布和大小的影响因体位不同而不同,并与进出口压差密切相关,提示,若血管进出口压差较小,忽略重力影响,不考虑体位改变,以二维轴对称模型来研究血管中血流状态,须谨慎解释所得结果.
Gravity is the most fundamental biomechanical stimulus for posture change. Pressure of blood flow is one of primary indicators to evaluate cardiovascular performance. Up to now, the underlying mechanism of effects of posture change on cardiovascular system is still unclear. A 3D FSI mathematical model with posture change was presented. By applying the body force terms to the fluid equation and the vessel wall equation, the model could be used to study posture change and the effects of gravity on the pressure of blood flow quantitively. Under different inlet-outlet pressure difference(IODP) and different postures such as horizontal, upright and upside-down one, the effects of gravity were simulated. In horizontal position, the pressure distributions of blood flow transformed from 2D(two-dimensional) axis-symmetry without gravity to 3D asymmetry with gravity under small IODP. With IODP increasing, gravity had less effects on pressure distribution and extreme value. As IODP reached 10 665.6 Pa(80 mmHg) and 2 666.4 Pa(20 mmHg) respectively, this effect was observed to be constant. Similar results were obtained from 3D fluid-only model. In either upright or upside-down position, 2D axis-symmetric pressure distribution was observed with and without gravity, yet the position, in which extreme pressure appeared, was different in upright position from that in upside-down one. Finally, the effect intensity of gravity in upright or upside-down position was more than twice as much as that in horizontal one. The results indicate that introducing body force term into the fluid and solid equations to present a novel model, which was based on hemodynamics, will provide a new way to study posture change. Effects of gravity on pressure distribution and extreme value changed with different postures and IODP. If IODP is small, ignoring effect of gravity and postures so as to simplify the hemodynamics model to 2D axis-symmetric one, the conclusion should be drawn with caution.
牟文英,虞钢,庄逢源.重力对锥形血管中血流压力的影响——基于考虑体位改变的三维流固耦合数学模型[J].生物化学与生物物理进展,2009,36(10):1340-1347
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