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β-肾上腺素能阻滞剂对人体低氧和高氧运动时通气反应的影响。

Effects of beta-adrenergic blockade on the ventilatory responses to hypoxic and hyperoxic exercise in man.

作者信息

Conway M A, Petersen E S

机构信息

University Laboratory of Physiology, Oxford.

出版信息

J Physiol. 1987 Dec;393:43-55. doi: 10.1113/jphysiol.1987.sp016809.

Abstract
  1. The ventilatory responses to step changes from rest to 100 W cycling exercise were studied in five healthy human subjects. Exercise was performed in hypoxia (end-tidal O2 pressure, PET,O2, 50-55 mmHg), a condition characterized by a marked enhancement of arterial chemoreceptor activity, and in hyperoxia (PET,O2 greater than 250 mmHg), a condition in which arterial chemoreceptor activity is largely suppressed. The subjects were studied at each O2 level after placebo and after an oral dose of 120 mg propranolol. 2. The magnitude of phase 1, the immediate, rapid ventilatory response at the onset of work, was unaffected by hypoxia and at both oxygen levels it was also unaffected by propranolol. 3. Phase 2, analysed from 20 to 120 s after the onset of exercise, was significantly affected by both O2 level and beta-blockade. The kinetics of the ventilatory changes in this phase were well described in all four conditions by a simple exponential function. The overall mean time constants after placebo were shorter in hypoxia (31.0 s) than in hyperoxia (40.2 s), and at each O2 level longer after propranolol, in hypoxia 61.3 s and in hyperoxia 106.0 s. 4. Continuous analysis of gas sampled at the mouth with a mass spectrometer showed constancy of end-tidal PCO2 throughout the step change in hypoxia both with and without beta-blockade. In contrast, in both hyperoxic conditions PET,CO2 rose, mainly in phase 2, to a value 5-6 mmHg higher than the starting value. 5. The steady-state ventilation was higher in hypoxia than in hyperoxia, and end-tidal CO2 pressure, PET,CO2, correspondingly lower. Neither ventilation nor PCO2 were, however, affected by propranolol in either condition. 6. It is concluded that the arterial chemoreceptors are important for both the rate of adaptation of ventilation to a new rate of metabolism during a step change of work rate, and for the matching of ventilation to CO2 flow which normally ensures isocapnia. The further slowing of the dynamics of the ventilatory response in hyperoxia as well as the preserved isocapnia in hypoxia after beta-blockade argue against any major role of beta-adrenergic mechanisms for these functions of the arterial chemoreceptors. The observed effects are considered to be secondary to the reduced cardiac output and an increased CO2 storage initially during exercise following beta-adrenergic blockade.
摘要
  1. 对5名健康受试者进行了研究,观察他们从静息状态到100瓦骑行运动的阶跃变化时的通气反应。运动分别在低氧(呼气末氧分压,PET,O2,50 - 55 mmHg)和高氧(PET,O2大于250 mmHg)条件下进行,低氧状态下动脉化学感受器活性显著增强,高氧状态下动脉化学感受器活性在很大程度上受到抑制。在安慰剂处理后以及口服120毫克普萘洛尔后,对每个受试者在每种氧水平下进行研究。2. 第1阶段的幅度,即工作开始时立即出现的快速通气反应,不受低氧影响,并且在两种氧水平下均不受普萘洛尔影响。3. 第2阶段,从运动开始后20至120秒进行分析,受到氧水平和β受体阻滞剂的显著影响。在所有四种情况下,该阶段通气变化的动力学都能用一个简单的指数函数很好地描述。安慰剂处理后的总体平均时间常数在低氧时(31.0秒)比高氧时(40.2秒)短,并且在每种氧水平下,普萘洛尔处理后时间常数更长,低氧时为61.3秒,高氧时为106.0秒。4. 用质谱仪对口腔采集的气体进行连续分析表明,在低氧条件下,无论有无β受体阻滞剂,在整个阶跃变化过程中呼气末PCO2保持恒定。相比之下,在两种高氧条件下,PET,CO2升高,主要在第2阶段,升高至比起始值高5 - 6 mmHg的值。5. 低氧时的稳态通气高于高氧时,呼气末二氧化碳分压PET,CO2相应较低。然而,在两种情况下,通气和PCO2均不受普萘洛尔影响。6. 得出结论,动脉化学感受器对于工作率阶跃变化期间通气适应新代谢率的速率以及通气与二氧化碳流量的匹配(这通常确保等碳酸血症)都很重要。高氧时通气反应动力学的进一步减慢以及β受体阻滞剂处理后低氧时等碳酸血症的维持表明,β肾上腺素能机制在动脉化学感受器的这些功能中不起主要作用。观察到的效应被认为是继发于β肾上腺素能阻断后运动开始时心输出量减少和二氧化碳储存增加。

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