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未麻醉小马在高原停留期间的脑脊液碱中毒

Cerebrospinal fluid alkalosis during high-altitude sojourn in unanesthetized ponies.

作者信息

Orr J A, Bisgard G E, Forster H V, Buss D D, Dempsey J A, Will J A

出版信息

Respir Physiol. 1975 Oct;25(1):23-37. doi: 10.1016/0034-5687(75)90048-1.

DOI:10.1016/0034-5687(75)90048-1
PMID:241107
Abstract

Unanesthetized adult female ponies were studied near sea level (250 m) and during sojourns to 3400 m (N=6) and 4300 m (N=7) altitude. The pH, PCO2, and PO2 of arterial blood and pH and PCO2 of cerebrospinal fluid (CSF) were measured under conditions of acute (1 hr) and chronic (1-45 days) hypoxia. Cerebrospinal fluid was sampled from the cisterna magna of the awake pony and arterial blood withdrawn from an indwelling arterial catheter. In both groups of animals, PaCO2 decreased slightly after 1 hr of hypoxia (delta PaCO2= - 0.6 mm Hg at 3400 m; - 3.9 mm Hg at 4300 m), decreased further after 1-5 days at high altitude (delta PaCO2= - 7.2 mm Hg at 3400 m; - 12.3 mm Hg at 4300 m) and then increased significantly after 6 days of chronic hypoxia (delta PaCO2= + 4.1 mm Hg at 3400 m; + 4.7 mm Hg at 4300 m). Although PaO2 decreased markedly during acute hypoxia, subsequent changes in PaCO2 at high altitude did not alter PaO2 from that observed during acute hypoxia (PaO2=52 mm Hg at 3400 m; 41 mm Hg at 4300 m). The pH of CSF increased during acute hypoxia (delta pH= + 0.013 unit at 3400 m; + 0.033 unit at 4300 m) and became more alkaline after 1-2 days at high altitude (delta pH= + 0.031 unit at 3400 m; + 0.064 unit at 4300 m). At 4300 m, CSF pH remained alkaline to control values throughout sojourn. Under these conditions of chronic hypocapnic hypoxia, CSF pH was imperfectly regulated and regulated in a magnitude equal to (3400 m) or less than (4300 m) arterial blood. Furthermore, the similarity of relative changes in CSF [HCO3-] and arterial [HCO3-] during chronic hypoxia may indicate a passive regulation of CSF [HCO3-] rather than local 'CSF-specific' mechanisms as previously proposed.

摘要

对未麻醉的成年雌性小马在海平面附近(250米)以及在海拔3400米(N = 6)和4300米(N = 7)的停留期间进行了研究。在急性(1小时)和慢性(1 - 45天)缺氧条件下,测量了动脉血的pH、PCO₂和PO₂以及脑脊液(CSF)的pH和PCO₂。从清醒小马的枕大池采集脑脊液,从留置的动脉导管抽取动脉血。在两组动物中,缺氧1小时后PaCO₂略有下降(3400米处ΔPaCO₂ = - 0.6毫米汞柱;4300米处为 - 3.9毫米汞柱),在高海拔停留1 - 5天后进一步下降(3400米处ΔPaCO₂ = - 7.2毫米汞柱;4300米处为 - 12.3毫米汞柱),然后在慢性缺氧6天后显著升高(3400米处ΔPaCO₂ = + 4.1毫米汞柱;4300米处为 + 4.7毫米汞柱)。尽管急性缺氧期间PaO₂显著下降,但高海拔时随后的PaCO₂变化并未改变急性缺氧时观察到的PaO₂(3400米处PaO₂ = 52毫米汞柱;4300米处为41毫米汞柱)。脑脊液的pH在急性缺氧期间升高(3400米处ΔpH = + 0.013单位;4300米处为 + 0.033单位),在高海拔停留1 - 2天后变得更碱(3400米处ΔpH = + 0.031单位;4300米处为 + 0.064单位)。在4300米处,整个停留期间脑脊液pH相对于对照值保持碱性。在这些慢性低碳酸血症性缺氧条件下,脑脊液pH调节不完善,调节幅度等于(3400米)或小于(4300米)动脉血。此外,慢性缺氧期间脑脊液[HCO₃⁻]和动脉[HCO₃⁻]相对变化的相似性可能表明脑脊液[HCO₃⁻]是被动调节,而不是如先前提出的局部“脑脊液特异性”机制。

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