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过度通气导致的低碳酸血症性碱中毒会减缓中等强度运动时肺摄取 O2 和腿部血液动力学。

Pulmonary O2 uptake and leg blood flow kinetics during moderate exercise are slowed by hyperventilation-induced hypocapnic alkalosis.

机构信息

Canadian Centre for Activity and Aging, School of Kinesiology, Department of Physiology and Pharmacology, Arthur and Sonia Labatt Health Sciences Bldg., Rm. 411C, The University of Western Ontario, London, ON, Canada N6A 5B9.

出版信息

J Appl Physiol (1985). 2010 Jun;108(6):1641-50. doi: 10.1152/japplphysiol.01346.2009. Epub 2010 Mar 25.

Abstract

The effect of hyperventilation-induced hypocapnic alkalosis (Hypo) on the adjustment of pulmonary O2 uptake (VO2p) and leg femoral conduit artery ("bulk") blood flow (LBF) during moderate-intensity exercise (Mod) was examined in eight young male adults. Subjects completed four to six repetitions of alternate-leg knee-extension exercise during normal breathing [Con; end-tidal partial pressure of CO2 (PetCO2) approximately 40 mmHg] and sustained hyperventilation (Hypo; PetCO2 approximately 20 mmHg). Increases in work rate were made instantaneously from baseline (3 W) to Mod (80% estimated lactate threshold). VO2p was measured breath by breath by mass spectrometry and volume turbine, and LBF (calculated from mean femoral artery blood velocity and femoral artery diameter) was measured simultaneously by Doppler ultrasound. Concentration changes of deoxy (Delta[HHb])-, oxy (Delta[O2Hb])-, and total hemoglobin-myoglobin (Delta[HbTot]) of the vastus lateralis muscle were measured continuously by near-infrared spectroscopy (NIRS). The kinetics of VO2p, LBF, and Delta[HHb] were modeled using a monoexponential equation by nonlinear regression. The time constants for the phase 2 VO2p (Hypo, 49+/-26 s; Con, 28+/-8 s) and LBF (Hypo, 46+/-16 s; Con, 23+/-6 s) were greater (P<0.05) in Hypo compared with Con. However, the mean response time for the overall Delta[HHb] response was not different between conditions (Hypo, 23+/-5 s; Con, 24+/-3 s), whereas the Delta[HHb] amplitude was greater (P<0.05) in Hypo (8.05+/-7.47 a.u.) compared with Con (6.69+/-6.31 a.u.). Combined, these results suggest that hyperventilation-induced hypocapnic alkalosis is associated with slower convective (i.e., slowed femoral artery and microvascular blood flow) and diffusive (i.e., greater fractional O2 extraction for a given DeltaVO2p) O2 delivery, which may contribute to the hyperventilation-induced slowing of VO2p (and muscle O2 utilization) kinetics.

摘要

在 8 名年轻男性成年人中,研究了过度通气诱导的低碳酸血症性碱中毒(Hypo)对中等强度运动(Mod)期间肺 O2 摄取(VO2p)和腿部股骨导血管(“总体”)血流(LBF)调节的影响。受试者在正常呼吸[Con;呼气末二氧化碳分压(PetCO2)约 40mmHg]和持续过度通气(Hypo;PetCO2 约 20mmHg)期间完成了交替腿伸膝运动的 4 至 6 次重复。工作率从基线(3 W)瞬间增加到 Mod(80%估计的乳酸阈)。通过质谱和体积涡轮机逐口气测量 VO2p,并通过多普勒超声同时测量 LBF(根据股动脉平均血流速度和股动脉直径计算)。通过近红外光谱(NIRS)连续测量股外侧肌脱氧(Delta[HHb])、氧合(Delta[O2Hb])和总血红蛋白-肌红蛋白(Delta[HbTot])的浓度变化。通过非线性回归使用单指数方程对 VO2p、LBF 和 Delta[HHb]的动力学进行建模。Hypo 时,VO2p 第二相的时间常数(Hypo,49+/-26 s;Con,28+/-8 s)和 LBF(Hypo,46+/-16 s;Con,23+/-6 s)大于 Con(P<0.05)。然而,两种条件下的总体 Delta[HHb]反应的平均响应时间没有差异(Hypo,23+/-5 s;Con,24+/-3 s),而 Hypo 时的 Delta[HHb]幅度更大(P<0.05)(Hypo,8.05+/-7.47 a.u.)与 Con(6.69+/-6.31 a.u.)相比。综上所述,过度通气诱导的低碳酸血症性碱中毒与更慢的对流(即股动脉和微血管血流减慢)和扩散(即给定 DeltaVO2p 时更大的分数 O2 提取)O2 输送有关,这可能导致过度通气引起的 VO2p(和肌肉 O2 利用)动力学减慢。

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