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人类对2小时持续性低氧的通气反应。

Ventilatory response to 2-h sustained hypoxia in humans.

作者信息

Garcia N, Hopkins S R, Elliott A R, Aaron E A, Weinger M B, Powell F L

机构信息

Laboratoire Réponses Cellulaires et Fonctionnelles à l'Hypoxie, UFR Médecine, Université Paris 13, 93012, Bobigny, France.

出版信息

Respir Physiol. 2001;124(1):11-22. doi: 10.1016/s0034-5687(00)00183-3.

Abstract

We used two protocols to determine if hypoxic ventilatory decline (HVD) involves changes in slope and/or intercept of the isocapnic HVR (hypoxic ventilatory response, expressed as the increase in VI per percentage decrease in SaO2). Isocapnia was defined as 1.5 mmHg above hyperoxic PET(CO2). HVD was recorded in protocol I during two sequential 25 min exposures to isocapnic hypoxia (85 and 75% SaO2, n=7) and in protocol II during 14 min of isocapnic hypoxia (90% SaO2, FIO2=0.13, n=15), extended to 2 h of hypoxia with CO2-uncontrolled in eight subjects. HVR was measured by the step reduction to sequentially lower levels of SaO2 in protocol I and by 3 min steps to 80% SaO2 at 8, 14 and 120 min in protocol II. The intercept of the HVR (VI predicted at SaO2=100%) decreased after 14 and 25 min in both protocols (P<0.05). Changes in slope were observed only in protocol I at SaO2=75%, suggesting that the slope of the HVR is more sensitive to depth than duration of hypoxic exposure. After 2 h of hypoxia the HVR intercept returned toward control value (P<0.05) with still no significant changes in the HVR slope. We conclude that HVD in humans involves a decrease in hyperoxic ventilatory drive that can occur without significant change in slope of the HVR. The partial reversal of the HVD after 2 h of hypoxia may reflect some components of ventilatory acclimatization to hypoxia.

摘要

我们采用了两种方案来确定低氧通气下降(HVD)是否涉及等碳酸血症性低氧通气反应(HVR,以每降低1%的动脉血氧饱和度(SaO2)时每分钟通气量(VI)的增加来表示)的斜率和/或截距的变化。等碳酸血症定义为高于高氧状态下呼气末二氧化碳分压(PET(CO2))1.5 mmHg。在方案I中,对7名受试者进行连续两次25分钟的等碳酸血症性低氧暴露(分别为85%和75%的SaO2)来记录HVD;在方案II中,对15名受试者进行14分钟的等碳酸血症性低氧暴露(90%的SaO2,吸入氧分数(FIO2)=0.13),并对其中8名受试者在二氧化碳未控制的情况下将低氧暴露延长至2小时。在方案I中,通过逐步降低SaO2水平来测量HVR;在方案II中,在8、14和120分钟时通过3分钟的步骤将SaO2降至80%来测量HVR。在两个方案中,14分钟和25分钟后HVR的截距(预测的SaO2 = 100%时的VI)均下降(P<0.05)。仅在方案I中,当SaO2 = 75%时观察到斜率变化,这表明HVR的斜率对低氧暴露的深度比对持续时间更敏感。低氧暴露2小时后,HVR截距恢复至对照值(P<0.05),而HVR斜率仍无显著变化。我们得出结论,人类的HVD涉及高氧通气驱动力的降低,且这种降低可能在HVR斜率无显著变化的情况下发生。低氧暴露2小时后HVD的部分逆转可能反映了对低氧通气适应的某些成分。

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