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支气管激发试验对稳定期哮喘患者呼吸模式和动脉血氧合的影响。

Effect of bronchial challenge on breathing patterns and arterial oxygenation in stable asthma.

作者信息

Stewart I C, Parker A, Catterall J R, Douglas N J, Flenley D C

机构信息

Rayne Laboratory, Department of Respiratory Medicine, University of Edinburgh, City Hospital, Scotland.

出版信息

Chest. 1989 Jan;95(1):65-70. doi: 10.1378/chest.95.1.65.

Abstract

The effect of histamine or methacholine inhalational challenge on breathing patterns and oxygen saturation was investigated in ten stable asthmatic patients. We used the respiratory inductive plethysmograph to record respiratory timing and minute ventilation along with an ear oximeter to measure oxygen saturation (SaO2). As FEV1 fell during the challenge procedure, SaO2 also fell (average 3 percent). Furthermore, with histamine challenge, expiratory time (Te), inspiratory time (Ti), and breath period (Ttot) all increased; minute ventilation probably also fell. These changes in breathing pattern and SaO2 were reversed by inhalation of a beta 2-agonist. However, no such changes in breathing patterns were observed with methacholine challenge despite a similar fall in FEV1. Bronchial challenge produces hypoxia in stable asthmatic patients, which might result from a combination of hypoventilation with alteration in alveolar ventilation/perfusion relationships.

摘要

在10名病情稳定的哮喘患者中,研究了组胺或乙酰甲胆碱吸入激发试验对呼吸模式和血氧饱和度的影响。我们使用呼吸感应体积描记器记录呼吸时间和分钟通气量,同时使用耳式血氧计测量血氧饱和度(SaO2)。在激发试验过程中,随着第一秒用力呼气容积(FEV1)下降,SaO2也下降(平均下降3%)。此外,组胺激发试验时,呼气时间(Te)、吸气时间(Ti)和呼吸周期(Ttot)均增加;分钟通气量可能也下降。吸入β2激动剂可逆转呼吸模式和SaO2的这些变化。然而,乙酰甲胆碱激发试验时,尽管FEV1有类似下降,但未观察到呼吸模式有此类变化。支气管激发试验会使病情稳定的哮喘患者出现低氧血症,这可能是通气不足与肺泡通气/灌注关系改变共同作用的结果。

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