Dolmage T E, Avendano M A, Goldstein R S
Dept of Medicine, University of Toronto, West Park Hospital, Canada.
Eur Respir J. 1992 Jul;5(7):864-70.
The purpose of this study was to determine whether there is a difference in respiratory mechanics and gas exchange between polio survivors and healthy, age-matched controls during wakefulness and sleep. Polio survivors were divided into four groups. The first group included those who had evidence of respiratory muscle involvement originally (PRM) and the second group included those who had bulbar muscle involvement originally (PBM). The third and fourth groups had only limb involvement originally but were separated by absence (PSL) or presence of a scoliosis (PSS) at the time of their evaluation. Each subject completed baseline and one year follow-up measurements of lung volumes, diffusion, flow rates, respiratory muscle strength, central and peripheral chemoreflexes and arterial blood gases. Sleep measurements included a full respiratory polysomnographic study. Fifty polio survivors and 13 controls completed the study. The PRM and PSS groups had an elevated arterial carbon dioxide tension (PaCO2) (mean +/- SE 6.0 +/- 0.4 and 6.0 +/- 0.3 kPa, respectively), reduced vital capacity (2.8 +/- 0.3 and 2.9 +/- 0.3 l, respectively), reduced maximal inspiratory pressure (-5.9 +/- 0.7 and -5.4 +/- 0.8 kPa, respectively) and reduced maximal expiratory pressure (9.8 +/- 1.1 and 9.1 +/- 1.2 kPa, respectively), when compared with non-polio controls. During sleep PRM and PSS groups experienced a higher PaCO2 (6.5 +/- 0.5 and 6.7 +/- 0.4 kPa, respectively) and a lower arterial oxygen saturation (SaO2) (89 +/- 4 and 86 +/- 3%, respectively). There were no differences among groups for diffusion, flow rates and chemoreflexes. All other polio survivors showed essentially normal respiratory function.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的目的是确定脊髓灰质炎幸存者与年龄匹配的健康对照者在清醒和睡眠期间呼吸力学和气体交换是否存在差异。脊髓灰质炎幸存者被分为四组。第一组包括最初有呼吸肌受累证据的患者(PRM),第二组包括最初有延髓肌受累的患者(PBM)。第三组和第四组最初仅有肢体受累,但在评估时根据是否存在脊柱侧凸(PSS)或不存在脊柱侧凸(PSL)进行区分。每位受试者均完成了肺容积、弥散、流速、呼吸肌力量、中枢和外周化学反射以及动脉血气的基线和一年随访测量。睡眠测量包括完整的呼吸多导睡眠图研究。50名脊髓灰质炎幸存者和13名对照者完成了研究。与非脊髓灰质炎对照组相比,PRM组和PSS组的动脉二氧化碳分压(PaCO2)升高(分别为均值±标准误6.0±0.4和6.0±0.3 kPa),肺活量降低(分别为2.8±0.3和2.9±0.3 l),最大吸气压力降低(分别为-5.9±0.7和-5.4±0.8 kPa),最大呼气压力降低(分别为9.8±1.1和9.1±1.2 kPa)。在睡眠期间,PRM组和PSS组的PaCO2更高(分别为6.5±0.5和6.7±0.4 kPa),动脉血氧饱和度(SaO2)更低(分别为89±4%和86±3%)。各组在弥散、流速和化学反射方面无差异。所有其他脊髓灰质炎幸存者的呼吸功能基本正常。(摘要截选至250字)