Mortola J P, Rezzonico R, Fisher J T, Villena-Cabrera N, Vargas E, Gonzáles R, Peña F
Department of Physiology, McGill University, Montreal, Quebec, Canada.
Am Rev Respir Dis. 1990 Jul;142(1):43-8. doi: 10.1164/ajrccm/142.1.43.
Populations living at high altitude are known to have a number of distinctive physiologic traits, including an increase in lung volume and compliance. We asked whether the factors that result in the increased compliance of high altitude natives were sufficiently expressed in utero that an increase in respiratory system compliance (Crs) could be detected at birth. Measurements were performed at about 1 day after birth on 34 infants born in La Paz, Bolivia (3,600 m, Pb about 495 mm Hg) and 36 born in Santa Cruz (400 m, Pb about 735 mm Hg). All infants were full-term and healthy, with body weights of at least 2,700 g. We measured Crs from expirations within the tidal volume range by the multiple occlusion method. Breathing pattern was measured from the spirometric record, and an index of chest wall distortion was obtained from the ratio of volume and abdominal displacement during spontaneous breathing and relaxations against closed airways. Rib cage and abdomen dimensions did not differ between the two groups. Crs values in Santa Cruz were similar to those previously obtained in Montreal and in other Caucasian infant populations at low altitudes. Crs was 33% and Crs/kg 37% greater (p less than 0.001) in the high altitude group, which included equal numbers of Amerindians and Mestizos of European ancestry. Dynamic elevation of the end-expiratory level was similar in both groups. Ventilation/kg and the distortion ratio were slightly yet significantly higher in the high altitude infants, suggesting an increased ventilatory drive.(ABSTRACT TRUNCATED AT 250 WORDS)
众所周知,生活在高海拔地区的人群具有许多独特的生理特征,包括肺容积和顺应性增加。我们想了解导致高海拔地区原住民顺应性增加的因素在子宫内是否充分表达,以至于在出生时就能检测到呼吸系统顺应性(Crs)增加。对出生于玻利维亚拉巴斯(海拔3600米,气压约495毫米汞柱)的34名婴儿和出生于圣克鲁斯(海拔400米,气压约735毫米汞柱)的36名婴儿在出生后约1天进行了测量。所有婴儿均为足月儿且健康,体重至少2700克。我们通过多次阻断法在潮气量范围内呼气时测量Crs。从肺活量记录中测量呼吸模式,并通过自发呼吸和气道闭合时放松过程中容积与腹部位移的比值获得胸壁变形指数。两组之间胸廓和腹部尺寸无差异。圣克鲁斯的Crs值与之前在蒙特利尔和其他低海拔白种人婴儿群体中获得的值相似。高海拔组的Crs值高33%,Crs/体重高37%(p<0.001),该组中美洲印第安人和欧洲血统的混血儿数量相等。两组呼气末水平的动态升高相似。高海拔婴儿的每千克通气量和变形率略高但有显著差异,表明通气驱动力增加。(摘要截短于250字)