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迷走神经在完整和消除颈动脉化学反射情况下对降低的动脉血氧分压的通气反应中的作用。

The role of the vagus nerves in the ventilatory response to lowered PaO2 with intact and eliminated carotid chemoreflexes.

作者信息

Kiwull-Schöne H, Kiwull P

出版信息

Pflugers Arch. 1979 Jul;381(1):1-9. doi: 10.1007/BF00582324.

Abstract

In anaesthetized rabbits the influence of vagal cold-block on the ventilatory response to lowered arterial oxygen pressure was investigated. With intact carotid chemoreflexes, lowered PaO2 caused hyperventilation, which was progressively intensified with the degree of hypoxia, regardless of whether the alveolar PCO2 was uncontrolled or kept constant at the hyperoxic control. The V-PaO2 response was to a greater extent due to an increase of respiratory rate than to one of tidal volume. During hyperoxia, vagal cold-block caused a distinct increase in ventilation provided the alveolar PCO2 was not allowed to decrease. During moderate hypoxia, vagal block caused only a slight increase in ventilation, when PACO2 was not controlled, but a distinct decrease in ventilation, when PACO2 was maintained at the hyperoxic level. Without carotid chemoreflexes, lowered PaO2 did not change ventilation at any level, provided the vagus nerves were left intact. This was due to a substantial increase in respiratory rate counteracting a corresponding decrease in tidal volume. Then vagal block led to a ventilatory depression depending on the degree of hypoxia, which was due to a simultaneous decline in respiratory rate and tidal volume. It is concluded that during hypocapnic hypoxia the vagal stretch reflex primarily inhibits the carotid chemoreflex drive of ventilation. During normocapnic hypoxia, however, the mode of interaction between the peripheral and the central chemical drive has to be considered, which without vagal feed-back is occlusive. This occlusion appears to be counteracted by a vagal mechanism sensitive to CO2 in the airways--and possibly also to a lack of O2--, mainly shortening respiratory cycle duration.

摘要

在麻醉兔身上,研究了迷走神经冷阻断对动脉血氧分压降低时通气反应的影响。在完整的颈动脉化学反射情况下,无论肺泡PCO₂是否不受控制或在高氧对照时保持恒定,PaO₂降低都会引起过度通气,且随着缺氧程度的加重而逐渐增强。V-PaO₂反应在很大程度上是由于呼吸频率增加而非潮气量增加。在高氧期间,如果不允许肺泡PCO₂降低,迷走神经冷阻断会导致通气明显增加。在中度缺氧时,当PACO₂不受控制时,迷走神经阻断仅导致通气略有增加;而当PACO₂维持在高氧水平时,则导致通气明显减少。如果保留迷走神经完整,在没有颈动脉化学反射的情况下,任何水平的PaO₂降低都不会改变通气。这是由于呼吸频率大幅增加抵消了潮气量相应的减少。此时迷走神经阻断会导致通气抑制,其程度取决于缺氧程度,这是由于呼吸频率和潮气量同时下降所致。得出的结论是,在低碳酸血症性缺氧期间,迷走神经牵张反射主要抑制颈动脉化学反射对通气的驱动。然而,在正常碳酸血症性缺氧期间,必须考虑外周和中枢化学驱动之间的相互作用模式,在没有迷走神经反馈的情况下,这种相互作用是闭塞性的。这种闭塞似乎被一种对气道中的CO₂(可能也对O₂缺乏)敏感的迷走神经机制所抵消,主要是缩短呼吸周期时长。

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