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健康活跃男性和女性在恒定负荷运动期间的肺泡-动脉气体交换。

Alveolar to arterial gas exchange during constant-load exercise in healthy active men and women.

作者信息

Schwartz Jesse C, Snyder Eric M, Olson Thomas P, Johnson Bruce D, Wheatley-Guy Courtney M

机构信息

Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.

Geneticure, Inc., Rochester, MN, USA.

出版信息

J Sports Sci. 2021 May;39(9):961-968. doi: 10.1080/02640414.2020.1851927. Epub 2020 Nov 26.

DOI:10.1080/02640414.2020.1851927
PMID:33242298
Abstract

Inadequate hyperventilation and inefficient alveolar to arterial gas exchange are gas exchange challenges that can limit capacity and cause exercise-induced arterial hypoxaemia (EIAH). This work evaluated if the prevalence of gas exchange inefficiencies, defined as AaDO>25 mmHg, PaCO>38 mmHg, and/or ΔPaO>-10 mmHg at any point during constant-load exercise in healthy, active, but not highly trained, individuals suggested an innate sex difference that would make females more susceptible to EIAH. Sixty-four healthy, active males and females completed 18-min of cycling exercise (moderate and vigorous intensity, 9 min/stage). Arterial blood gases were measured at rest and every 3-min during exercise, while constantly assessing gas exchange. Both sexes demonstrated similar levels of AaDO widening until the final 3 min of vigorous exercise, where females demonstrated a trend for greater widening than males (16.3±6.2 mmHg vs. 19.1±6.0 mmHg, p=0.07). Males demonstrated a blunted ventilatory response to moderate exercise with higher PaCO (38.5±2.6 vs. 36.5±2.4, p=0.002) and a lower ventilation when corrected for workload (0.42±0.1 vs. 0.48±0.1, p=0.002). No significant arterial hypoxaemia occurred, but in 6 M and 5 F SaO dropped by ≥2%. There was no difference in prevalence of pulmonary gas exchange inefficiencies between sexes, but the type of inefficiency was influenced by sex. AaDO: alveolar-arterial oxygen difference; BP: blood pressure; EIAH: exercise-induced arterial hypoxaemia; F: females; HR: heart rate; M: males; Q: cardiac output; PaCO: arterial partial pressure of carbon dioxide; PaO: arterial partial pressure of oxygen; ΔPaO: change in arterial partial pressure of oxygen; PAO: alveolar partial pressure of oxygen; RPE: rating of perceived exertion; SaO: arterial oxygen saturation; V: ventilation; V/VCO: ventilatory equivalent for carbon dioxide; VO: peak oxygen consumption; W: workload maximum.

摘要

通气不足和肺泡与动脉之间低效的气体交换是气体交换方面的挑战,可能会限制运动能力并导致运动诱发的动脉血氧不足(EIAH)。这项研究评估了在健康、活跃但未经过高强度训练的个体进行恒定负荷运动期间,任何时间点气体交换低效的发生率(定义为肺泡动脉氧分压差(AaDO)>25 mmHg、动脉血二氧化碳分压(PaCO)>38 mmHg和/或动脉血氧分压变化(ΔPaO)>-10 mmHg)是否表明存在先天性别的差异,使得女性更容易发生EIAH。64名健康、活跃的男性和女性完成了18分钟的骑行运动(中等强度和高强度,每个阶段9分钟)。在休息时以及运动期间每3分钟测量一次动脉血气,同时持续评估气体交换。在高强度运动的最后3分钟之前,两性的AaDO增加水平相似,但在该阶段女性的AaDO增加趋势大于男性(16.3±6.2 mmHg对19.1±6.0 mmHg,p = 0.07)。男性对中等强度运动的通气反应迟钝,PaCO较高(38.5±2.6对36.5±2.4,p = 0.002),并且校正工作量后的通气量较低(0.42±0.1对0.48±0.1,p = 0.002)。未发生明显的动脉血氧不足,但有6名男性和5名女性的动脉血氧饱和度(SaO)下降了≥2%。两性之间肺气体交换低效的发生率没有差异,但低效的类型受性别影响。AaDO:肺泡动脉氧分压差;BP:血压;EIAH:运动诱发的动脉血氧不足;F:女性;HR:心率;M:男性;Q:心输出量;PaCO:动脉血二氧化碳分压;PaO:动脉血氧分压;ΔPaO:动脉血氧分压变化;PAO:肺泡氧分压;RPE:自觉用力程度分级;SaO:动脉血氧饱和度;V:通气量;V/VCO:二氧化碳通气当量;VO:峰值耗氧量;W:最大工作量

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