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乙醇引起的低氧驱动抑制及纳洛酮的逆转作用——性别差异

Ethanol-induced depression of hypoxic drive and reversal by naloxone--a sex difference.

作者信息

McCauley V B, Grunstein R R, Sullivan C E

机构信息

Department of Medicine, University of Sydney, N.S.W. Australia.

出版信息

Am Rev Respir Dis. 1988 Jun;137(6):1406-10. doi: 10.1164/ajrccm/137.6.1406.

Abstract

The effects of ethanol ingestion and subsequent intravenously administered naloxone on the ventilatory response to hypercapnic hypoxia in 8 normal males and 8 normal females were examined. The responses of controls were lower in the females (-0.63 +/- 0.07 L/min/% SaO2) than the males (-1.11 +/- 0.18 L/min/% SaO2). Alcohol depressed the male response to a mean of -0.50 +/- 0.08 L/min/%SaO2 (p less than 0.01) but increased the mean female response to -0.87 +/- 0.11 L/min/%SaO2 (p less than 0.01). Naloxone reversed the ethanol-induced depression of the hypercapnic hypoxic response in males, but had no effect on the female response. In males there was a direct correlation between the magnitude of the initial hypoxic response and the extent of depression by ethanol; the higher the response the greater the depression. Females showed a significant direct correlation between the blood alcohol and the increase in hypercapnic hypoxic slope, whereas males showed a weaker inverse correlation to blood alcohol level. These results demonstrate that ethanol depresses male but not female hypoxic ventilatory responsiveness and suggest that this is mediated by opioid-like mechanisms. Because the alcohol-induced depression was seen in subjects with a high control hypoxic response, the male-female difference might simply reflect initially lower control responses in females. This suggests a qualitative difference in hypoxic ventilatory control mechanisms between sexes.

摘要

研究了8名正常男性和8名正常女性摄入乙醇及随后静脉注射纳洛酮对高碳酸血症性低氧通气反应的影响。女性对照组的反应(-0.63±0.07L/min/%SaO₂)低于男性(-1.11±0.18L/min/%SaO₂)。酒精使男性反应平均降至-0.50±0.08L/min/%SaO₂(p<0.01),但使女性平均反应增加至-0.87±0.11L/min/%SaO₂(p<0.01)。纳洛酮逆转了乙醇引起的男性高碳酸血症性低氧反应抑制,但对女性反应无影响。在男性中,初始低氧反应的幅度与乙醇引起的抑制程度之间存在直接相关性;反应越高,抑制越明显。女性血液酒精含量与高碳酸血症性低氧斜率增加之间存在显著直接相关性,而男性与血液酒精水平呈较弱的负相关。这些结果表明,乙醇抑制男性而非女性的低氧通气反应性,并提示这是由类阿片机制介导的。由于在高对照低氧反应的受试者中观察到酒精引起的抑制作用,男女差异可能仅仅反映了女性最初较低的对照反应。这表明男女在低氧通气控制机制上存在质的差异。

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