Kawakami Y, Yoshikawa T, Yamamoto H, Nishimura M
Respiration. 1985;47(4):247-52. doi: 10.1159/000194779.
Relation of threshold for perception of added inspiratory flow resistance to ventilatory and occlusion pressure response to hypercapnia during external flow-resistive loading was examined in 8 healthy volunteers and 14 patients with chronic obstructive pulmonary disease. Occlusion pressure response to hypercapnia without the load and the threshold for perception were similar between normal subjects and patients. Occlusion pressure at end-tidal PCO2 of 60 mm Hg increased to 134 +/- (SD) 23.4% (p less than 0.01) in normal subjects, but it did not change in patients (113.7 +/- 25.3%). Occlusion pressure response to hypercapnia increased to 155.4 +/- 60% (p less than 0.05) during ventilatory loading in normal subjects but it did not change in patients (105.9 +/- 33%). Inverse correlation between threshold values and changes after loading in occlusion pressure response to hypercapnia was seen in patients as well as in normal subjects. These results indicate in both normal subjects and patients with chronic obstructive pulmonary disease that occlusion pressure response to hypercapnia during the ventilatory loading includes signals from the higher central nervous system and that the lower the threshold, the higher the respiratory drive during the loaded ventilation.
在8名健康志愿者和14名慢性阻塞性肺疾病患者中，研究了在外部流阻负荷期间，额外吸气流阻感知阈值与高碳酸血症通气和闭塞压反应之间的关系。在无负荷情况下，正常受试者和患者对高碳酸血症的闭塞压反应以及感知阈值相似。正常受试者在呼气末PCO2为60 mmHg时的闭塞压增加到134±（标准差）23.4%（p<0.01），但患者没有变化（113.7±25.3%）。在通气负荷期间，正常受试者对高碳酸血症的闭塞压反应增加到155.4±60%（p<0.05），但患者没有变化（105.9±33%）。在患者和正常受试者中均观察到阈值与高碳酸血症闭塞压反应负荷后变化之间呈负相关。这些结果表明，在正常受试者和慢性阻塞性肺疾病患者中，通气负荷期间对高碳酸血症的闭塞压反应包括来自高级中枢神经系统的信号，并且阈值越低，负荷通气期间的呼吸驱动力越高。
