Zavorsky G S, Hoffman S L
Department of Obstetrics, Gynecology and Women's Health, School of Medicine, Saint Louis University, Saint Mary's Health Center, Saint Louis, Missouri 63117, USA.
Obes Rev. 2008 Jul;9(4):326-39. doi: 10.1111/j.1467-789X.2008.00471.x. Epub 2008 Mar 4.
The literature on pulmonary gas exchange at rest, during exercise, and with weight loss in the morbidly obese (body mass index or BMI > or = 40 kg m(-2)) is reviewed. Forty-one studies were found (768 subjects weighted mean = 40 years old, BMI = 48 kg m(-2)). The alveolar-to-arterial oxygen partial pressure difference (AaDO2) was large at rest in upright subjects at sea level (23, range 5-38 mmHg) while the arterial pressure of oxygen (PaO2) was low (81, range 50-95 mmHg). Arterial pressure of carbon dioxide (PaCO2) was normal. At peak exercise (162 W), gas exchange improves. Weight loss of 45 kg (BMI = -13 kg m(-2)) over 18 months is associated with an improvement in PaO2 (by 10 mmHg, range 1-23 mmHg), a reduction in AaDO2 (by 8 mmHg, range -3 to -16 mmHg), and PaCO2 (by -3 mmHg, range 3 to -14 mmHg) at rest. Every 5-6 kg reduction in weight increases PaO2 by 1 and reduces AaDO2 by 1 mmHg, respectively. Morbidly obese women have better gas exchange at rest compared with morbidly obese men which is likely due to lower waist-to-hip ratios in women than from differences in weight or BMI.
本文综述了关于病态肥胖者（体重指数或BMI≥40kg/m²）静息、运动及减重过程中肺气体交换的文献。共检索到41项研究（768名受试者，加权平均年龄 = 40岁，BMI = 48kg/m²）。海平面直立位受试者静息时，肺泡 - 动脉氧分压差（AaDO2）较大（23，范围5 - 38mmHg），而动脉血氧分压（PaO2）较低（81，范围50 - 95mmHg）。动脉血二氧化碳分压（PaCO2）正常。运动峰值（162W）时，气体交换改善。18个月内减重45kg（BMI = -13kg/m²）与静息时PaO2改善（升高10mmHg，范围1 - 23mmHg）、AaDO2降低（降低8mmHg，范围 -3至 -16mmHg）及PaCO2降低（降低 -3mmHg，范围3至 -14mmHg）相关。体重每减轻5 - 6kg，PaO2分别升高1mmHg，AaDO2降低1mmHg。与病态肥胖男性相比，病态肥胖女性静息时气体交换更好，这可能是由于女性腰臀比更低，而非体重或BMI的差异。
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