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突然气道高碳酸血症对人体运动性通气增强起始的影响。

The effects of sudden airway hypercapnia on the initiation of exercise hyperpnoea in man.

作者信息

Ward S A

出版信息

J Physiol. 1979 Nov;296:203-14. doi: 10.1113/jphysiol.1979.sp013000.

Abstract
  1. In three healthy individuals, the first breath of cycle ergometer exercise was characterized by increases of minute ventilation (VE) and pulmonary capillary CO2 output (VCO2), with little change of end-tidal PCO2, suggesting a concomitant increase of pulmonary blood flow (Q) and preservation of V/Q status. Functional residual capacity fell, depleting lung gas stores of O2 and CO2. 2. The following hypothesis purporting to account for the initiation of exercise hyperpnoea was examined (Filley, 1976): (a) assuming pulmonary capillary plasma to remain unexposed to carbonic anhydrase, its slow alkalinization consequent upon CO2 exchange causes a more acid plasma to enter the pulmonary veins if Q increases abruptly, as at exercise onset; (b) the fall of pulmonary venous plasma pH stimulates an intrapulmonary chemoreflux to elicit a proportionate hyperpnoea, so preserving arterial isocapnia; (c) the initial hyperpnoea should therefore be abolished if pulmonary capillary VCO2 is suppressed at exercise onset, as the absence of pulmonary capillary plasma alkalinization should sever the postulated intrapulmonary humoral link between Q and VE. 3. In the present study, while abrupt CO2 inhalation (approximately 6% in air) at exercise onset abolished pulmonary capillary VCO2 during the first breath of exercise, the initial hyperpnoea was unaffected. This observation argues against the hypothesis that exercise hyperpnoea is initiated by an intrapulmonary chemoreflex which detects perfusion-related changes in pulmonary venous plasma pH.
摘要
  1. 在三名健康个体中,周期测力计运动的第一口气表现为分钟通气量(VE)和肺毛细血管二氧化碳排出量(VCO2)增加,而呼气末PCO2变化不大,这表明肺血流量(Q)同时增加且V/Q状态得以维持。功能残气量下降,耗尽了肺内的氧气和二氧化碳气体储备。2. 检验了以下旨在解释运动性呼吸急促起始原因的假说(菲利,1976年):(a)假设肺毛细血管血浆未接触碳酸酐酶,那么在二氧化碳交换后其缓慢碱化会导致如果Q突然增加(如运动开始时),更酸的血浆进入肺静脉;(b)肺静脉血浆pH值下降会刺激肺内化学反射,引发相应的呼吸急促,从而维持动脉血等碳酸状态;(c)因此,如果在运动开始时抑制肺毛细血管VCO2,初始呼吸急促应该会消除,因为肺毛细血管血浆碱化的缺失应该会切断假定的Q与VE之间的肺内体液联系。3. 在本研究中,虽然在运动开始时突然吸入二氧化碳(空气中约6%)消除了运动第一口气时的肺毛细血管VCO2,但初始呼吸急促并未受到影响。这一观察结果与运动性呼吸急促是由检测肺静脉血浆pH值中与灌注相关变化的肺内化学反射引发的假说相悖。

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本文引用的文献

2
Breathing in brief exercise.简短呼吸练习。
J Appl Physiol. 1960 Jul;15:583-8. doi: 10.1152/jappl.1960.15.4.583.
6
Carbonic anhydrase: chemistry, physiology, and inhibition.碳酸酐酶:化学、生理学及抑制作用
Physiol Rev. 1967 Oct;47(4):595-781. doi: 10.1152/physrev.1967.47.4.595.
8
Cardiodynamic hyperpnea: hyperpnea secondary to cardiac output increase.
J Appl Physiol. 1974 Apr;36(4):457-64. doi: 10.1152/jappl.1974.36.4.457.

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