Regnard J
Laboratoire de Physiologie, Faculté de Médecine, Besançon, France.
Int J Sports Med. 1992 Oct;13 Suppl 1:S182-4. doi: 10.1055/s-2007-1024633.
Physiological and pathological respiratory responses are triggered by various conditions of exposure to cold climates. Beside airway smooth muscle, both the pulmonary and the tracheobronchial vasculatures are major effectors of respiratory responses to cold. General exposure to cold causes pulmonary vasoconstriction known as "Raynaud's phenomenon of the lung" in subjects with primary Raynaud syndrome and favors acute pulmonary oedema in subjects with congestive heart failure. In healthy subjects acute hyperventilation of very cold air has led to acute respiratory failure closely similar to hypoxic pulmonary oedema. In outdoor exercising people years long repetition of hyperventilation of subfreezing air causes "eskimo lung" made of obstructive lung disease and increased wall thickness of pulmonary arteries. At a lesser degree hyperventilation of dry air cools the central airways and triggers subclinical bronchial obstruction in healthy subjects. In asthmatic subjects hyperventilation of dry air causes asthma attacks. Results of recent animal and human experiments point to a key role of mucosal vessels in thermal balance of the airways. Simultaneously, there is increasing evidence that hyperventilation-induced asthma is triggered by a thermal stimulus.
生理和病理呼吸反应由暴露于寒冷气候的各种情况引发。除气道平滑肌外，肺血管和气管支气管血管系统都是对寒冷的呼吸反应的主要效应器。一般暴露于寒冷会导致原发性雷诺综合征患者出现被称为“肺雷诺现象”的肺血管收缩，并会促使充血性心力衰竭患者发生急性肺水肿。在健康受试者中，吸入极冷空气导致的急性过度通气已引发与低氧性肺水肿极为相似的急性呼吸衰竭。在户外锻炼的人群中，多年来反复吸入冰点以下的空气进行过度通气会导致由阻塞性肺病和肺动脉壁增厚构成的“爱斯基摩肺”。在较轻程度上，干燥空气的过度通气会使中央气道冷却，并在健康受试者中引发亚临床支气管阻塞。在哮喘患者中，干燥空气的过度通气会引发哮喘发作。近期动物和人体实验结果表明黏膜血管在气道热平衡中起关键作用。同时，越来越多的证据表明过度通气诱发的哮喘由热刺激引发。
