Respiratory Investigation Unit, Department of Medicine, Queen's University c/o Kingston General Hospital, Kingston, Ontario, Canada.
Respir Physiol Neurobiol. 2011 Jan 31;175(1):55-61. doi: 10.1016/j.resp.2010.09.007. Epub 2010 Sep 17.
We examined the impact of human pregnancy on breathlessness intensity at matched levels of ventilation (V˙E) during isoxic hyperoxic CO₂ rebreathing and incremental cycle exercise tests in 21 healthy women in the third trimester (TM₃) and again ∼5 months post-partum (PP). Pregnancy had no significant (P > 0.05) effect on the slope or threshold of the breathlessness intensity-V˙E relationship during both exercise and rebreathing. By contrast, the slope of the breathlessness intensity-V˙E relationship was significantly higher, while the threshold of this relationship was consistently lower during rebreathing vs. exercise (both P < 0.05), regardless of pregnancy status (P > 0.05). As a result, breathlessness intensity was markedly higher at any given V˙E (e.g., by ∼4 Borg units at 40 L/min) during rebreathing vs. exercise, regardless of pregnancy status. Inter-subject variation in breathlessness intensity-V˙E slopes during exercise was not associated with inter-subject variation in breathlessness intensity-V˙E slopes during rebreathing or with increased central chemoreflex responsiveness during pregnancy (both P > 0.05). In conclusion, the intensity of perceived breathlessness for a given V˙E depends, at least in part, on the nature and source of increased central respiratory motor command output, independent of pregnancy status; and pregnancy-induced increases in activity-related breathlessness cannot be easily explained by increased central chemoreflex responsiveness.
我们在 21 名处于孕晚期(TM₃)和产后约 5 个月的健康女性中,在等通气(V˙E)水平下,分别在异氧高氧 CO₂再呼吸和递增周期运动试验中,检查了妊娠对呼吸困难强度的影响。在运动和再呼吸过程中,妊娠对呼吸困难强度-V˙E 关系的斜率或阈值均无显著影响(P>0.05)。相比之下,无论妊娠状态如何(P>0.05),再呼吸时的斜率均显著升高,而该关系的阈值始终较低(两者均 P<0.05)。因此,在任何给定的 V˙E 时,再呼吸时的呼吸困难强度明显更高(例如,在 40 L/min 时高约 4 个 Borg 单位),而与妊娠状态无关。运动时呼吸困难强度-V˙E 斜率的个体间变异性与再呼吸时呼吸困难强度-V˙E 斜率的个体间变异性或妊娠期间中枢化学感受器反射敏感性的增加无关(两者均 P>0.05)。总之,对于给定的 V˙E,感知呼吸困难的强度至少部分取决于中枢呼吸运动指令输出的性质和来源,而与妊娠状态无关;并且妊娠引起的与活动相关的呼吸困难增加不能简单地用中枢化学感受器反射敏感性增加来解释。