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运动后的肺功能,特别强调弥散能力。

Pulmonary function after exercise with special emphasis on diffusion capacity.

作者信息

Hanel B

机构信息

Department of Anaesthesia, Rigshospitalet, Copenhagen.

出版信息

Dan Med Bull. 2000 Jun;47(3):196-217.

Abstract

The present work focuses on pulmonary gas exchange during repeated rowing to exhaustion and the recovery of pulmonary diffusion capacity for carbon monoxide (DL) after exercise in healthy young subjects. The components of DL are examined at rest using the single breath method at two different alveolar O2 tensions. Electrical impedance and 99mTechnetium labelled erythrocytes were used to evaluate the recovery of blood distribution. Special attention has been given to the role of the inspiratory muscles as a limiting factor for VO2max and performance. The documentation in this study of a reduced DL several hours after exercise conflicts with the prerequisites of optimal conditions for high metabolic rates in elite athletes. Even low intensity exercise induces a reduction in DL, and together with the fact that a diuretic does not attenuate this decrease, emphasises that the reduction in DM is not due to an interstitial pulmonary edema. The major part of the reduction is due to a decreased CBV reflected in a reduction of VC and a minor part is caused by an injury to the membrane component carried over from exercise. The ability in athletes to repeat exhaustive exercise within 2 h indicates that the slow recovery of DL is not combined with either impaired pulmonary gas exchange or performance. Thus, an acute diffusion limitation and a low pH cause the desaturation in some athletes during exhaustive exercise. Despite the inspiratory muscles having a slower response to endurance training compared with the cardiovascular system, selective training of the inspiratory muscles does not improve either VO2max or performance. This indicates that maximal inspiratory pressure is not a limiting factor for maximal exercise and that the stimuli to increase VA depends on an increased metabolic rate; stressing the role of the peripheral chemoreceptors. Together with the post-exercise decrease in ANP, the reduction in DL may be involved in the mechanism increasing the total blood volume in endurance trained athletes.

摘要

本研究聚焦于健康年轻受试者在重复划船至力竭过程中的肺气体交换以及运动后一氧化碳肺弥散能力(DL)的恢复情况。采用单次呼吸法在两种不同肺泡氧张力下于静息状态检测DL的组成部分。使用电阻抗和99m锝标记红细胞评估血液分布的恢复情况。特别关注吸气肌作为最大摄氧量(VO2max)和运动表现限制因素的作用。本研究中关于运动数小时后DL降低的记录与精英运动员高代谢率最佳条件的前提相矛盾。即使是低强度运动也会导致DL降低,并且利尿剂并不能减轻这种降低,这强调了DL降低并非由于间质性肺水肿。降低的主要部分是由于肺血容量(CBV)减少反映为肺活量(VC)降低,而次要部分是由运动遗留的膜成分损伤所致。运动员在2小时内重复进行力竭运动的能力表明,DL的缓慢恢复并未伴随着肺气体交换受损或运动表现下降。因此,急性弥散限制和低pH值导致一些运动员在力竭运动期间出现氧饱和度降低。尽管与心血管系统相比,吸气肌对耐力训练的反应较慢,但对吸气肌进行选择性训练并不能提高VO2max或运动表现。这表明最大吸气压力不是最大运动的限制因素,增加肺泡通气量(VA)的刺激取决于代谢率的增加;强调了外周化学感受器的作用。连同运动后心房利钠肽(ANP)的降低,DL的降低可能参与了耐力训练运动员增加总血容量的机制。

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