患有囊性纤维化的年轻患者在二氧化碳重复呼吸期间的机械限制。

Mechanical limitation during CO2 rebreathing in young patients with cystic fibrosis.

作者信息

Fauroux Brigitte, Nicot Frédéric, Boelle Pierre-Yves, Boulé Michèle, Clément Annick, Lofaso Frédéric, Bonora Monique

机构信息

Pediatric Pulmonary Department, Armand Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

出版信息

Respir Physiol Neurobiol. 2006 Oct 27;153(3):217-25. doi: 10.1016/j.resp.2005.11.002. Epub 2005 Dec 27.

DOI:10.1016/j.resp.2005.11.002

PMID:16377261

Abstract

The aim of the study was to determine whether a decrease in the ventilatory response to carbon dioxide (CO2) in children with cystic fibrosis (CF) is related to a mechanical limitation of the respiratory muscle capacity. The ventilatory response during CO2 rebreathing was performed in 15 patients (mean forced expiratory volume in 1 s (FEV1): 37 +/- 21% predicted, mean arterial CO2: 41+/- 5 mmHg). The slope of the minute ventilation normalised for weight per mmHg CO2 increment correlated negatively with respiratory muscle output, assessed by the oesophageal (p = 0.002), the diaphragmatic pressure time product (p = 0.01), and the tension time index (p = 0.005). In addition, this slope was correlated with dynamic lung compliance (p < 0.0001) and FEV1 (p = 0.03) but not with airway resistance and maximal transdiaphragmatic pressure. Therefore, an excessive load imposed on the respiratory muscles explains the blunting of the ventilatory response to CO2 in young patients with CF.

摘要

本研究的目的是确定囊性纤维化（CF）患儿对二氧化碳（CO₂）的通气反应降低是否与呼吸肌容量的机械限制有关。对15例患者进行了CO₂重复呼吸期间的通气反应测试（1秒用力呼气量（FEV₁）均值：为预测值的37±21%，平均动脉CO₂：41±5 mmHg）。每毫米汞柱CO₂增量的体重标准化分钟通气斜率与呼吸肌输出呈负相关，呼吸肌输出通过食管压力（p = 0.002）、膈肌压力时间乘积（p = 0.01）和张力时间指数（p = 0.005）进行评估。此外，该斜率与动态肺顺应性（p < 0.0001）和FEV₁（p = 0.03）相关，但与气道阻力和最大跨膈压无关。因此，呼吸肌承受的过重负荷解释了CF年轻患者对CO₂通气反应的减弱。