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高代谢对通气和化学敏感性的影响。

Effects of hypermetabolism on ventilation and chemosensitivity.

作者信息

Zwillich C W, Sahn S A, Weil J V

出版信息

J Clin Invest. 1977 Oct;60(4):900-6. doi: 10.1172/JCI108844.

Abstract

Muscular exercise is associated with hypermetabolism and increased hypoxic ventilatory response (HVR). In order to dissociate mechanical and metabolic factors, the effect of hypermetabolism on hypoxic ventilatory response was evaluated at rest. Carbohydrate and protein feeding increases metabolic rate, and their effects on chemosensitivity, ventilation, and blood pH were evaluated in six normal subjects 2 h and 3 h after calorically equal test meals (1,000 cal). After carbohydrate, base-line oxygen consumption (Vo(2)) increased from 237+/-11.3 ml/min (SEM) to 302+/-19.4 (P < 0.001) and 303+/-18.5 (P < 0.001) at 2 h and 3 h, respectively. Hypoxic ventilatory response, measured as shape parameter A, increased from a control of 144+/-11.8 to 330+/-61.0 (P < 0.01) at 2 h and 286+/-57.0 (P < 0.05) at 3 h. These changes were associated with a mild metabolic acidosis as pH decreased from a control of 7.402+/-0.004 to 7.371+/-0.009 (P < 0.005) at 2 h and 7.377+/-0.008 (P < 0.005) at 3 h. After protein, Vo(2) increased from 241+/-6.7 to 265+/-6.2 (P < 0.02) and 270+/-5.4 (P < 0.001), an overall increase less than that which occurred after carbohydrate (P < 0.01). Hypoxic ventilatory response increased from 105+/-14.5 to 198+/-24.3 (P < 0.02) at 2 h and 219+/-17.3 (P < 0.01) at 3 h, which was not different from the increase with carbohydrate. After protein, no acidosis occurred. Thus, after protein, HVR increased despite the absence of a systemic acidosis. We conclude that both carbohydrate and protein feedings are associated with resting hypermetabolism and increased HVR compared with the fasting state. For both meals, increased metabolic rate was correlated with increased hypoxic response.

摘要

肌肉运动与高代谢及增强的低氧通气反应(HVR)相关。为了区分机械因素和代谢因素,在静息状态下评估了高代谢对低氧通气反应的影响。给予碳水化合物和蛋白质后可提高代谢率,并在给予热量相等的试验餐(1000千卡)后2小时和3小时,对6名正常受试者的化学敏感性、通气和血液pH值的影响进行了评估。给予碳水化合物后,基础耗氧量(Vo₂)在2小时时从237±11.3毫升/分钟(标准误)增至302±19.4(P<0.001),在3小时时增至303±18.5(P<0.001)。以形状参数A衡量的低氧通气反应在2小时时从对照值144±11.8增至330±61.0(P<0.01),在3小时时增至286±57.0(P<0.05)。这些变化伴随着轻度代谢性酸中毒,pH值在2小时时从对照值7.402±0.004降至7.371±0.009(P<0.005),在3小时时降至7.377±0.008(P<0.005)。给予蛋白质后,Vo₂从241±6.7增至265±6.2(P<0.02),并在3小时时增至270±5.4(P<0.001),总体增幅小于给予碳水化合物后的增幅(P<0.01)。低氧通气反应在2小时时从105±14.5增至198±24.3(P<0.02),在3小时时增至219±17.3(P<0.01),与给予碳水化合物后的增幅无差异。给予蛋白质后未发生酸中毒。因此,给予蛋白质后,尽管没有全身性酸中毒,HVR仍增加。我们得出结论,与空腹状态相比,给予碳水化合物和蛋白质均与静息高代谢及HVR增加相关。对于这两种餐食,代谢率增加均与低氧反应增加相关。

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