Huckauf H, Schäfer J H, Kollo D
Bull Eur Physiopathol Respir. 1976 Jan-Feb;12(1):129-45.
The oxygen affinity of hemoglobin and the factors determining the position of the oxygen dissociation curve were investigated in twenty-five patients with severe chronic obstructive lung disease. Patients have been separated into three groups: group I showed a normal or mild decrease of PaO2, group II a moderate fall in arterial oxygen pressure, and group III a severe hypoxia with balanced acid-base equilibrium and hypercapnia. Blood hemoglobin exhibited a significant increase in all groups, indicating an improved oxygen transport. In most patients a leftward shifting of the oxygen dissociation curve occurred. It is discussed that the tendency to left shifting is based upon alkalosis inside the red cells, evidently demonstrated in all groups studied. 2,3-diphosphoglycerate showed no close relation to evaluated oxygen affinity of hemoglobin. The evidence for an increased oxygen affinity may reveal a further compensatory mechanism in oxygen transport in patients with pulmonary disorders. Additionally the alkalosis inside the cells may counterbalance too great a right shifting of oxygen dissociation curve in vivo when severe hypoxia and hypercapnia occur.
对25例重度慢性阻塞性肺疾病患者的血红蛋白氧亲和力及决定氧解离曲线位置的因素进行了研究。患者被分为三组：第一组动脉血氧分压（PaO₂）正常或轻度降低；第二组动脉血氧压力中度下降；第三组为严重缺氧且酸碱平衡和高碳酸血症。所有组的血液血红蛋白均显著增加，表明氧运输得到改善。大多数患者的氧解离曲线向左移动。据讨论，向左移动的趋势是基于红细胞内的碱中毒，在所研究的所有组中均明显表现出来。2,3-二磷酸甘油酸与评估的血红蛋白氧亲和力无密切关系。氧亲和力增加的证据可能揭示了肺部疾病患者氧运输中的一种进一步的代偿机制。此外，当发生严重缺氧和高碳酸血症时，细胞内的碱中毒可能在体内抵消氧解离曲线过度右移。
