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低氧血症时静脉血氧分压与肌肉血氧分压的关系。

Relationship of venous PO2 to muscle PO2 during hypoxemia.

作者信息

Gutierrez G, Lund N, Acero A L, Marini C

机构信息

Division of Pulmonary Medicine, University of Texas Health Science Center, Houston 77030.

出版信息

J Appl Physiol (1985). 1989 Sep;67(3):1093-9. doi: 10.1152/jappl.1989.67.3.1093.

Abstract

Anesthetized mechanically ventilated rabbits were subjected to progressive hypoxemia (n = 7) to determine the relationship of venous PO2 (PvO2) to skeletal muscle PO2 (PtiO2). Measures of arterial PO2 (PaO2), right atrial PO2 [(PvO2)RA], and hindlimb PO2 [(PvO2)limb], were obtained from the carotid artery, right atrium, and inferior vena cava, just above the level of the iliac bifurcation. Biceps femoris muscle PtiO2 was measured with a surface O2 microelectrode having eight measuring points. PaO2 was decreased from 90.3 +/- 5.4 to 26.8 +/- 0.8 Torr in five consecutive steps, followed by reoxygenation to 105.6 +/- 10.5 (SE) Torr. Measurements were obtained after each decrement in PaO2. A total of 128 measures of PtiO2 were obtained per experimental stage. The mean and distribution of the muscle PtiO2 histogram were determined. Measurements were compared with analysis of variance and the Newman-Keuls post hoc method. (PvO2)limb had similar values as the average muscle PtiO2 (PtiO2) for PaO2 values greater than 52.1 +/- 4.3 Torr, where (PvO2)limb became greater than PtiO2 (P less than 0.05). The lowest measures of (PvO2)limb and PtiO2 were 15.9 +/- 0.7 and 4.0 +/- 0.1 Torr, respectively (P less than 0.01). The PtiO2 histograms showed no evidence of increased microvascular heterogeneity with hypoxemia. We conclude that in hypoxemia PvO2 is greater than muscle PtiO2. This difference may be related to the establishment of significant physicochemical O2 gradients from erythrocyte to tissue cell.

摘要

对麻醉状态下进行机械通气的家兔(n = 7)进行渐进性低氧血症实验,以确定静脉血氧分压(PvO2)与骨骼肌血氧分压(PtiO2)之间的关系。动脉血氧分压(PaO2)、右心房血氧分压[(PvO2)RA]和后肢血氧分压[(PvO2)limb]的测量值分别取自颈动脉、右心房和髂总静脉分叉上方的下腔静脉。股二头肌的PtiO2用具有八个测量点的表面氧微电极进行测量。PaO2以五个连续步骤从90.3±5.4 Torr降至26.8±0.8 Torr,随后再给氧至105.6±10.5(SE)Torr。在每次降低PaO2后进行测量。每个实验阶段共获得128个PtiO2测量值。确定肌肉PtiO2直方图的平均值和分布。测量值采用方差分析和Newman-Keuls事后检验法进行比较。当PaO2值大于52.1±4.3 Torr时,(PvO2)limb与平均肌肉PtiO2(PtiO2)的值相似,此后(PvO2)limb大于PtiO2(P<0.05)。(PvO2)limb和PtiO2的最低测量值分别为15.9±0.7 Torr和4.0±0.1 Torr(P<0.01)。PtiO2直方图未显示低氧血症时微血管异质性增加的迹象。我们得出结论,在低氧血症时,PvO2大于肌肉PtiO2。这种差异可能与从红细胞到组织细胞形成显著的物理化学氧梯度有关。

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