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脑脊液[H⁺]在慢性缺氧导致的通气脱适应中的作用。

Role of cerebrospinal fluid [H+] in ventilatory deacclimatization from chronic hypoxia.

作者信息

Dempsey J A, Forster H V, Bisgard G E, Chosy L W, Hanson P G, Kiorpes A L, Pelligrino D A

出版信息

J Clin Invest. 1979 Jul;64(1):199-205. doi: 10.1172/JCI109440.

Abstract

Once ventilatory acclimatization begins in sea level residents sojourning at high altitude, abrupt restoration of normal oxygen tensions will not restore ventilation to normal. We have investigated the role of cerebrospinal fluid (CSF) [H(+)] in this sustained hyperventilation by measuring CSF acid-base status in seven men (lumbar) and five ponies (cisternal) in normoxia, first at sea level and then periodically over 13-24 h of "deacclimatization" after 3-5 d in hypoxia (P(B) = 440 mm Hg). After 1 h deacclimatization, hyperventilation continued at a level only slightly less than that obtained in chronic hypoxia (+1-2 mm Hg Pa(CO2)), whereas CSF pH was either equal (in man) or alkaline (in pony, +0.02, P < 0.01) to sea level values. Between 1 and 12-13 h deacclimatization in all humans and ponies Va fell progressively (Pa(CO2) increased 4-7 mm Hg) and CSF pH became increasingly more acid (-0.02 to -0.05, P < 0.01). Between 12 and 24 h of normoxic deacclimatization in ponies, Pa(CO2) rose further toward normal, coincident with an increasing acidity in CSF (-0.02 pH). Similar negative correlations were found between changes in arterial pH and Va throughout normoxic deacclimatization. We conclude that [H(+)] in the lumbar or cisternal CSF is not the mediator of the continued hyperventilation and its gradual dissipation with time during normoxic deacclimatization from chronic hypoxia. These negative relationships of Va to CSF [H(+)] in normoxia are analogous to those previously shown during acclimatization to hypoxia.

摘要

一旦海平面居民在高海拔地区开始通气适应,突然恢复正常氧分压并不能使通气恢复正常。我们通过测量7名男性(腰椎)和5匹小马(枕骨大孔)在常氧状态下的脑脊液酸碱状态,研究了脑脊液[H⁺]在这种持续性过度通气中的作用。首先在海平面进行测量,然后在缺氧(P(B)=440mmHg)3 - 5天后,在常氧“去适应”的13 - 24小时内定期测量。去适应1小时后,过度通气仍持续,其水平仅略低于慢性缺氧时的水平(动脉血二氧化碳分压升高1 - 2mmHg),而脑脊液pH值与人在海平面时相等或在小马中呈碱性(升高0.02,P<0.01)。在所有人类和小马去适应1至12 - 13小时期间,每分通气量逐渐下降(动脉血二氧化碳分压升高4 - 7mmHg),脑脊液pH值变得越来越酸(下降0.02至0.05,P<0.01)。在小马常氧去适应12至24小时期间,动脉血二氧化碳分压进一步升至正常,同时脑脊液酸度增加(pH值下降0.02)。在整个常氧去适应过程中,动脉血pH值变化与每分通气量之间也发现了类似的负相关关系。我们得出结论,在从慢性缺氧进行常氧去适应过程中,腰椎或枕骨大孔脑脊液中的[H⁺]不是持续性过度通气及其随时间逐渐消散的介导因素。常氧状态下每分通气量与脑脊液[H⁺]之间的这些负相关关系类似于先前在适应缺氧过程中所显示的关系。

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