Dal Negro R W, Turco P A, Allegra L
Department of Clinical Respiratory Physiology, Bussolengo General Hospital, Verona, Italy.
Am Rev Respir Dis. 1992 Feb;145(2 Pt 1):337-9. doi: 10.1164/ajrccm/145.2_Pt_1.337.
Noninvasive blood gas monitoring is a new, simple, and reliable method for assessing hyperreactivity associated with bronchial asthma. In this study, 104 atopic rhinitic subjects with no history of wheezing and 104 healthy volunteers were challenged with ultrasonically nebulized distilled water (UNDW). Blood gases were monitored transcutaneously (PtcO2 and PtcCO2) over 42 min (20 min for electrode stabilization, 3 min for monitoring a steady baseline, 5 min during UNDW, and 14 min after UNDW). Mean baseline PtcO2 and PtcCO2 values were comparable in the two groups. In rhinitic subjects only, a sudden decrease in PtcCO2 (starting immediately after the beginning of the challenge and maximal 34.7 +/- 0.4 mm Hg SEM versus baseline 41.8 +/- 0.2 SEM mm Hg at the third minute of UNDW exposure) was induced by the challenge and proved significant (p less than 0.001). In the same subjects, a slightly delayed decrease in PtcO2 (starting immediately after the end of UNDW inhalation and maximal 64.5 +/- 1.1 mm Hg SEM versus baseline 78.3 +/- 0.7 SEM mm Hg at 4 min post-UNDW) was also induced by the challenge and proved highly significant (p less than 0.001). The effects of UNDW inhalation on blood gases in normal subjects were negligible and nonsignificant. UNDW in nonasthmatic rhinitis but not in normal subjects gives rise to a sudden hyperventilation and to gas-exchange abnormalities presumably reflecting a ventilation-perfusion mismatching, which, however, is of shorter duration in rhinitic than in asthmatic subjects.
无创血气监测是一种评估与支气管哮喘相关的高反应性的新的、简单且可靠的方法。在本研究中，对104名无喘息病史的特应性鼻炎患者和104名健康志愿者用超声雾化蒸馏水（UNDW）进行激发试验。在42分钟内经皮监测血气（PtcO2和PtcCO2）（电极稳定20分钟，监测稳定基线3分钟，UNDW期间5分钟，UNDW后14分钟）。两组的平均基线PtcO2和PtcCO2值相当。仅在鼻炎患者中，激发试验导致PtcCO2突然下降（在激发开始后立即开始，在UNDW暴露第3分钟时最大下降至34.7±0.4 mmHg SEM，而基线为41.8±0.2 SEM mmHg），且差异有统计学意义（p<0.001）。在同一组患者中，激发试验还导致PtcO2稍有延迟的下降（在UNDW吸入结束后立即开始，在UNDW后4分钟时最大下降至64.5±1.1 mmHg SEM，而基线为78.3±0.7 SEM mmHg），差异有高度统计学意义（p<0.001）。正常受试者吸入UNDW对血气的影响可忽略不计且无统计学意义。非哮喘性鼻炎患者吸入UNDW会引起突然的过度通气和气体交换异常，这可能反映了通气-灌注不匹配，然而，这种情况在鼻炎患者中的持续时间比哮喘患者短。
