Dept of Pulmonology, Medical University of Graz, Auenbruggerplatz 20, 8036 Graz, Austria.
Eur Respir J. 2012 Feb;39(2):319-28. doi: 10.1183/09031936.00008611. Epub 2011 Sep 1.
The physiological range of pulmonary vascular resistance (PVR) and total pulmonary resistance (TPR), and the impact of exercise, age and posture have been a matter of debate for many years. We performed a systematic literature review including all right heart catheterisation data where individual PVR and TPR of healthy subjects both at rest and exercise were available. Data were stratified according to age, exercise level and posture. Supine resting PVR in subjects aged <24 yrs, 24-50 yrs, 51-69 yrs and ≥70 yrs was 61±23, 69±28, 86±15 and 90±39 dyn·s·cm(-5), respectively. Corresponding TPR was 165±50, 164±46, 226±64 and 223±45 dyn·s·cm(-5), respectively. During moderate exercise in subjects aged ≤50 yrs, an 85% increase in cardiac output was associated with a 25% decrease in TPR (p<0.0001) and a 12% decrease in PVR (p<0.01). At 51-69 yrs of age there was no significant decrease in TPR and PVR. In individuals aged ≥70 yrs TPR even increased by 17% (p=0.01), while PVR did not change significantly. At higher exercise levels, TPR decreased in all age groups. In the upright position, based on a limited number of data, resting TPR and PVR were higher than in the supine position and decreased more prominently during exercise, suggesting the release of resting pulmonary vasoconstriction. These data may form a basis to define normal PVR at rest and exercise.
肺血管阻力（PVR）和总肺阻力（TPR）的生理范围，以及运动、年龄和体位的影响，多年来一直存在争议。我们进行了一项系统的文献综述，纳入了所有有个体 PVR 和 TPR 的右心导管检查数据，这些数据来自于健康受试者的静息和运动状态。数据根据年龄、运动水平和体位进行分层。年龄<24 岁、24-50 岁、51-69 岁和≥70 岁的受试者在仰卧位静息时的 PVR 分别为 61±23、69±28、86±15 和 90±39 dyn·s·cm(-5)，相应的 TPR 分别为 165±50、164±46、226±64 和 223±45 dyn·s·cm(-5)。在≤50 岁的受试者进行中等强度运动时，心输出量增加 85%，TPR 下降 25%（p<0.0001），PVR 下降 12%（p<0.01）。在 51-69 岁年龄组，TPR 和 PVR 没有显著下降。在≥70 岁的个体中，TPR 甚至增加了 17%（p=0.01），而 PVR 没有显著变化。在更高的运动水平下，所有年龄组的 TPR 都下降了。在直立位，基于有限的数据，静息 TPR 和 PVR 高于仰卧位，运动时下降更明显，提示静息时肺血管收缩的释放。这些数据可能为定义静息和运动时的正常 PVR 提供依据。
