运动性呼吸困难相关酸中毒和交感神经反应在肺结核后遗症患者中。
Exertional dyspnea-related acidotic and sympathetic responses in patients with sequelae of pulmonary tuberculosis.
机构信息
Department of Internal Medicine, National Hospital Organization Toneyama National Hospital, 5-1-1 Toneyama, Toyonaka, Osaka, Japan.
出版信息
J Physiol Sci. 2010 May;60(3):187-93. doi: 10.1007/s12576-009-0083-1. Epub 2010 Jan 20.
The objective of this study was to investigate whether exertional dyspnea correlates with exercise responses, especially arterial blood pH and plasma norepinephrine (NE) changes, in patients with sequelae of tuberculosis (TBsq). Cardiopulmonary exercise testings were performed in 49 TBsq patients and 9 controls. Each group had a break point in the dyspnea, plasma lactate, and plasma NE changes during exercise, all of which occurred at a similar exercise point. In TBsq patients in both exercise phases before and after the dyspnea break point, the dyspnea-slope (DeltaBorg scale/Deltaminute ventilation) correlated with the pH-slope (DeltapH/Deltaoxygen uptake) (r = -0.616, p < 0.0001; r = -0.629, p < 0.0001, respectively, before and after the break point) and with the NE-slope (DeltaNE/Deltaoxygen uptake) (r = 0.443, p = 0.0012; r = 0.643, p < 0.0001, respectively, before and after the break point). In TBsq patients during exercise, increases in circulating NE levels and exertional acidosis were correlated with exertional dyspnea.
本研究旨在探讨在肺结核后遗症（TBsq）患者中，运动性呼吸困难是否与运动反应相关，尤其是与动脉血 pH 值和血浆去甲肾上腺素（NE）变化相关。对 49 例 TBsq 患者和 9 例对照者进行了心肺运动试验。每组在运动过程中，呼吸困难、血浆乳酸和血浆 NE 变化都出现了转折点，这些转折点发生在相似的运动点。在呼吸困难转折点之前和之后的两个运动阶段中，TBsq 患者的呼吸困难斜率（DeltaBorg 量表/Delta 分钟通气量）与 pH 值斜率（DeltapH/Delta 摄氧量）（r = -0.616，p < 0.0001；r = -0.629，p < 0.0001，分别为转折点之前和之后）和 NE 斜率（DeltaNE/Delta 摄氧量）（r = 0.443，p = 0.0012；r = 0.643，p < 0.0001，分别为转折点之前和之后）相关。在 TBsq 患者运动期间，循环 NE 水平升高和运动性酸中毒与运动性呼吸困难相关。
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