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[呼吸调节的最新概念(作者译)]

[Recent concepts of respiratory regulation (author's transl)].

作者信息

Loeschcke H H

出版信息

Wien Klin Wochenschr. 1977 Jun 24;89(13):429-35.

PMID:17949
Abstract

There are two functional aspects of the respiratory control system, the one being adaptation of ventilation to metabolic needs and the other acid-base homeostasis of the extracellular fluid of the brain. These two functions are perfectly compatible with one another under normal conditions. During hypoxia or hyperthermia, however, a compromise has to be reaches by the system between securing oxygen availability or homeothermy, respectively and acid-base homeostasis of the brain. The control system works with tonic chemosensitive and non-chemosensitive neural input of action potentials to the centres. The centres, either by indigenous mechanisms or by phasic reflex input from the stretch receptors of the lungs or phasic feedback mechanisms from the pontine pneumotaxic centre, modulate the tonic impulse input into the rhythmic output to the respiratory muscles. Recent observations on this "inspiratory off switch mechanism" are discussed. Chemosensitive sensors are found in the carotid and aortic glomera responding to low pO2 and, additionally, to pH and pCO2 and in central chemosensitive structures on the ventral side of the medulla oblongata, responding mainly to changes in local hydrogen ion concentration. The proprioceptive reflexes in the sense of a gamma loop improve the performance of the system if additional flow resistance must be overcome. In metabolic and respiratory acidosis-alkalosis the kidney either plays a compensatory role or serves to restore normal conditions. The maternal hormones in pregnancy effect air improvement in CO2 output of the fetus.

摘要

呼吸控制系统有两个功能方面,一个是使通气适应代谢需求,另一个是维持脑细胞外液的酸碱平衡。在正常情况下,这两种功能彼此完美兼容。然而,在缺氧或体温过高时,该系统必须在确保氧气供应或体温恒定以及脑酸碱平衡之间达成妥协。控制系统通过向中枢发送动作电位的紧张性化学敏感和非化学敏感神经输入来工作。中枢通过自身机制或来自肺部牵张感受器的相位反射输入或来自脑桥呼吸调整中枢的相位反馈机制,调节进入呼吸肌节律性输出的紧张性冲动输入。讨论了关于这种“吸气切断开关机制”的最新观察结果。在颈动脉体和主动脉体中发现了化学敏感传感器,它们对低氧分压有反应,此外还对pH值和二氧化碳分压有反应;在延髓腹侧的中枢化学敏感结构中也有化学敏感传感器,主要对局部氢离子浓度的变化有反应。如果必须克服额外的流动阻力,γ环意义上的本体感受反射会改善系统的性能。在代谢性和呼吸性酸中毒 - 碱中毒中,肾脏要么起到代偿作用,要么有助于恢复正常状态。孕期母体激素会改善胎儿的二氧化碳排出。

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