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贫血对短暂性和稳态性低氧通气反应的影响。

The effect of anemia on the ventilatory response to transient and steady-state hypoxia.

作者信息

Santiago T V, Edelman N H, Fishman A P

出版信息

J Clin Invest. 1975 Feb;55(2):410-8. doi: 10.1172/JCI107945.

Abstract

The effects of anemia upon the ventilatory responses to transient and steady-state hypoxia were studied in unanesthetized goats. Responses to transient hypoxia (inhalation of several breaths of nitrogen) were considered to reflect peripheral chemoreceptor and non-chemoreceptor influences of hypoxia upon ventilatory control. In all goats, severe anemia (hemoglobin 3.1-4.8 g/100ml) markedly heightened the responses to transient hypoxia (from a mean of 0.27 to a mean of 0.75 liter/min/percent fall in SaO2). This phenomenon was substantially reversed by alpha-adrenergic blockade (phenoxybenzamine, 5 mg/kg). In contrast, the ventilatory responses to steady-state hypoxia were unaffected by severe anemia. These data suggest that severe anemia enhances the peripheral chemoreceptor-mediated response to hypoxia through a mechanism involving the alpha-adrenergic system. It also appears that a ventilatory depressant effect of hypoxia which is not mediated by the peripheral chemoreceptors is also enhanced by severe anemia, thereby preventing an increase in the steady-state ventilatory response to hypoxia. Finally, experiments involving variation in oxygen affinity of hemoglobin suggested that O2 tension rather than O2 availability in arterial blood is the major determinant of peripheral chemoreceptor activity.

摘要

在未麻醉的山羊身上研究了贫血对短暂性和持续性低氧通气反应的影响。对短暂性低氧(吸入几次氮气)的反应被认为反映了低氧对通气控制的外周化学感受器和非化学感受器影响。在所有山羊中,重度贫血(血红蛋白3.1 - 4.8 g/100ml)显著增强了对短暂性低氧的反应(从平均0.27升/分钟/ SaO₂下降百分比增至平均0.75升/分钟/ SaO₂下降百分比)。这种现象通过α - 肾上腺素能阻断(酚苄明,5 mg/kg)基本得到逆转。相比之下,重度贫血并未影响对持续性低氧的通气反应。这些数据表明,重度贫血通过涉及α - 肾上腺素能系统的机制增强了外周化学感受器介导的低氧反应。似乎重度贫血还增强了不由外周化学感受器介导的低氧通气抑制作用,从而阻止了对持续性低氧的通气反应增加。最后,涉及血红蛋白氧亲和力变化的实验表明,动脉血中的氧张力而非氧可用性是外周化学感受器活动的主要决定因素。

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