Burki N K
Department of Medicine, (Pulmonary and Critical Care Division), University of Kentucky Medical Center, Lexington.
Lung. 1987;165(5):269-77. doi: 10.1007/BF02714443.
Dyspnea, an unpleasant sensation of difficulty in breathing, is a common accompaniment of cardiopulmonary disease. The underlying mechanisms generating this sensation are not clearly understood. There does not appear to be any one specific site or specific receptor(s) involved in this sensation; however, reflex increase in central respiratory motor "command," as well as activity of the respiratory muscles, appear to be necessary for the genesis of the sensation. Whether there is a direct dyspnogenic effect of changes in chemical drive (increased arterial PCO2 or decreased arterial PO2) is unclear. Several methods to quantify dyspnea for clinical purposes have been described; techniques using exercise as the stimulus and expressing the response on a visual analogue or Borg category scale appear to be clinically applicable. The specific treatment of dyspnea remains in the experimental stage. The direct effects of exercise conditioning are unclear. A number of drugs (mainly central nervous system depressants) have been examined; preliminary work holds promise, but no particular drug can as yet be recommended for routine clinical use.
呼吸困难是一种呼吸费力的不适感，是心肺疾病常见的伴随症状。产生这种感觉的潜在机制尚不清楚。似乎不存在任何一个特定部位或特定受体参与这种感觉；然而，中枢呼吸运动“指令”的反射性增加以及呼吸肌的活动，似乎是产生这种感觉所必需的。化学驱动变化（动脉血二氧化碳分压升高或动脉血氧分压降低）是否具有直接的致呼吸困难作用尚不清楚。已经描述了几种用于临床目的量化呼吸困难的方法；使用运动作为刺激并在视觉模拟或博格分类量表上表达反应的技术似乎在临床上适用。呼吸困难的具体治疗仍处于实验阶段。运动训练的直接效果尚不清楚。已经研究了多种药物（主要是中枢神经系统抑制剂）；初步研究有前景，但目前还没有特别的药物可推荐用于常规临床使用。
