Kolarzyk E, Targosz D, Pach D, Misiołek L
Zakład Higieny i Ekologii Collegium Medicum, Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2000;57(10):531-5.
Neurotoxic properties of opioid drugs which are the central nervous system depressant may have also depressive action on the brain stem complex responsible for the breathing control. Disorders of breathing regulation are reflected in respiratory efficiency. The aim of this study was to evaluate the regulation of breathing by measuring of respiratory pattern parameters, occlusion pressure and also to estimate the respiratory efficiency in opiate abusers. There were 76 persons under examination: group I--36 opiates abusers (29 men and 7 women; mean age 22.6 years) treated in the Detoxification Unit of the Department of Clinical Toxicology; group II (control group)--40 healthy persons (25 men and 15 women; mean age 28 years) not dependent of opiates and never treated at the Department. During hospitalisation the functional state of respiratory system was monitored. Ventilation efficiency was determined on the basic of the results from a "flow-volume" curve, spirometry and the measurements of the respiratory tract resistance in a computerised system Lungtest-MES company (Poland). Respiratory regulation was evaluated by means of synchronic measurements of the respiratory pattern (according to the assumption of Milic-Emili) and occlusion pressure P 0.1 (according to Whitlaw assumptions). In the examination performed directly after admission to the Unit the normal respiratory efficiency was noted in 24 persons. 12 persons (33.3%) suffered from the bronchi obturation. In the examination performed after hospitalisation and 9 days of total abstinence the normal ventilatory efficiency was found in 23 persons. In 13 of the patients (38.5%) respiratory obturation was still observed. After treatment in group of opiate abusers compared to control group values of respiratory resistance, occlusion pressure, minute ventilation and VT/T(in) index describing the activity of the central breathing regulation were increased, while the time of expiration and time of total breathing cycle were shorter.
阿片类药物具有神经毒性，属于中枢神经系统抑制剂，可能对负责呼吸控制的脑干复合体也有抑制作用。呼吸调节紊乱反映在呼吸效率上。本研究的目的是通过测量呼吸模式参数、阻断压来评估呼吸调节，并估计阿片类药物滥用者的呼吸效率。共有76人接受检查：第一组——36名阿片类药物滥用者（29名男性和7名女性；平均年龄22.6岁），在临床毒理学系戒毒科接受治疗；第二组（对照组）——40名健康人（25名男性和15名女性；平均年龄28岁），不依赖阿片类药物，且从未在该科室接受过治疗。住院期间对呼吸系统的功能状态进行监测。根据“流量-容积”曲线、肺活量测定结果以及在波兰Lungtest-MES公司的计算机系统中测量呼吸道阻力来确定通气效率。通过同步测量呼吸模式（根据米利奇-埃米利的假设）和阻断压P0.1（根据惠特洛的假设）来评估呼吸调节。在入院后直接进行的检查中，24人呼吸效率正常。12人（33.3%）患有支气管阻塞。在住院及完全戒毒9天后进行的检查中，23人通气效率正常。13名患者（38.5%）仍观察到呼吸阻塞。与对照组相比，阿片类药物滥用者组治疗后，描述中枢呼吸调节活动的呼吸阻力、阻断压、分钟通气量和VT/T(in)指数值增加，而呼气时间和总呼吸周期时间缩短。
