Department of Pneumology, St. Elisabeth Hospital, Namur, Belgium.
J Appl Physiol (1985). 2013 Jul 15;115(2):157-66. doi: 10.1152/japplphysiol.01455.2012. Epub 2013 Apr 18.
Acute exposure to high altitude may induce changes in carbon monoxide (CO) membrane conductance (DmCO) and capillary lung volume (Vc). Measurements were performed in 25 lowlanders at Brussels (D0), at 4,300 m after a 2- or 3-day exposure (D2,3) without preceding climbing, and 5 days later (D7,8), before and after an exercise test, under a trial with two arterial pulmonary vasodilators or a placebo. The nitric oxide (NO)/CO transfer method was used, assuming both infinite and finite values to the NO blood conductance (θNO). Doppler echocardiography provided hemodynamic data. Compared with sea level, lung diffusing capacity for CO increased by 24% at D2,3 and is returned to control at D7,8. The acute increase in lung diffusing capacity for CO resulted from increases in DmCO and Vc with finite and infinite θNO assumptions. The alveolar volume increased by 16% at D2,3 and normalized at D7,8. The mean increase in systolic arterial pulmonary pressure at rest at D2,3 was minimal. In conclusion, the acute increase in Vc may be related to the increase in alveolar volume and to the increase in capillary pressure. Compared with the infinite θNO value, the use of a finite θNO value led to about a twofold increase in DmCO value and to a persistent increase in DmCO at D7,8 compared with D0. After exercise, DmCO decreased slightly less in subjects treated by the vasodilators, suggesting a beneficial effect on interstitial edema.
急性暴露于高海拔可能导致一氧化碳(CO)膜电导(DmCO)和毛细血管肺容积(Vc)的变化。在没有预先攀登的情况下,在布鲁塞尔(D0)、海拔 4300 米处暴露 2 或 3 天后(D2、3)以及 5 天后(D7、8)进行了测量,在试验中使用了两种动脉肺血管扩张剂或安慰剂。使用一氧化氮(NO)/CO 转移方法,假设 NO 血液传导率(θNO)具有无限大和有限值。多普勒超声心动图提供了血流动力学数据。与海平面相比,D2、3 时 CO 的肺弥散能力增加了 24%,并在 D7、8 时恢复到对照值。CO 的肺弥散能力的急性增加是由于 DmCO 和 Vc 的增加,假设 θNO 为有限和无限。D2、3 时肺泡容积增加 16%,D7、8 时恢复正常。D2、3 时静息状态下收缩期肺动脉压的平均升高最小。总之,Vc 的急性增加可能与肺泡容积的增加和毛细血管压力的增加有关。与无限 θNO 值相比,使用有限 θNO 值导致 DmCO 值增加约两倍,并且与 D0 相比,DmCO 值在 D7、8 时持续增加。运动后,接受血管扩张剂治疗的患者 DmCO 下降幅度略小,提示对间质水肿有有益作用。