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人体肺泡二氧化碳和氧气分压阶跃变化后的呼吸模式。

The pattern of breathing following step changes of alveolar partial pressures of carbon dioxide and oxygen in man.

作者信息

Gardner W N

出版信息

J Physiol. 1980 Mar;300:55-73. doi: 10.1113/jphysiol.1980.sp013151.

Abstract
  1. The pattern of breathing during the approach to the steady state following step changes of end-tidal P(CO2) and P(O2) has been determined in normal conscious human subjects. Three types of step were studied: (a) steps of P(A, CO2) against a constant background of hyperoxia (P(A, O2) approximately 200), an almost pure intracranial chemoreceptor stimulus, (b) steps of P(A, O2) between approximately 50 and 80 torr against a background of constant mild hypercapnia, an arterial chemoreceptor stimulus, and (c) steps of P(A, CO2) against a background of constant hypoxia (P(A, O2) approximately 50), a mixed stimulus. Steps were small and the responses barely detectable by the subjects.2. Steps of CO(2) in hyperoxia produced the slowest approach to the steady state. A single exponential fitted the ventilation response up to about 4 min (mean half time 83 sec for the ;up' and 69 sec for the ;down' transients). During the transient the pattern of change of tidal volume (V(T)) and expiratory time (T(E)) was the same as in the steady state. Inspiratory time (T(I)), however, in the early part of the transient, changed in the opposite direction to T(E), returning to its steady value only after 1(1/2)-3 min. This effect occurred in both ;up' and ;down' transients and resulted in a smaller change of respiratory frequency than would have been predicted from the steady-state response.3. Hypoxic steps produced the fastest approach to the steady state with mean half-times for ventilation of 10.9 sec for the ;up' transients and 6.6 sec for the ;down'. T(I) followed the same pattern during the transient as in the steady state, whereas T(E), following the step out of hypoxia, lengthened to far beyond its final steady value within five breaths of the step, only returning to its steady-state value 3-4 min after the step. This resulted in an exaggerated change of frequency during the early part of the transient.4. Steps of CO(2) in hypoxia, a mixed peripheral and central chemoreceptor stimulus, showed a ventilation response which was best fitted by two exponentials, the half-times of which were consistent with those obtained for the separate responses. The patterning was also consistent with a mixed response, more so for T(I) than for T(E).5. The steady-state pattern derived from the pre-switch means was consistent with the pattern previously described.6. Possible mechanisms are discussed. It is suggested that these results could explain the different patterns seen in the past by those using re-breathing and steady-state techniques.7. The validity of using one or two breath oxygen or nitrogen tests (or other similar tests) as a quantitative measure of the hypoxic response in man is questioned.
摘要
  1. 已在正常清醒的人类受试者中确定了在呼气末二氧化碳分压(P(CO2))和氧分压(P(O2))发生阶跃变化后接近稳态过程中的呼吸模式。研究了三种类型的阶跃:(a)在高氧背景(P(A, O2)约为200)下P(A, CO2)的阶跃,这几乎是一种纯粹的颅内化学感受器刺激;(b)在恒定轻度高碳酸血症背景下,P(A, O2)在约50至80托之间的阶跃,这是一种动脉化学感受器刺激;(c)在恒定低氧背景(P(A, O2)约为50)下P(A, CO2)的阶跃,这是一种混合刺激。阶跃幅度较小,受试者几乎检测不到反应。

  2. 高氧环境下二氧化碳的阶跃导致达到稳态的过程最慢。单个指数函数可拟合通气反应直至约4分钟(上升瞬变的平均半衰期为83秒,下降瞬变的平均半衰期为69秒)。在瞬变过程中,潮气量(V(T))和呼气时间(T(E))的变化模式与稳态时相同。然而,在瞬变的早期,吸气时间(T(I))的变化方向与T(E)相反,仅在1.5 - 3分钟后才恢复到其稳态值。这种效应在上升和下降瞬变中均会出现,导致呼吸频率的变化比根据稳态反应预测的要小。

  3. 低氧阶跃导致达到稳态的过程最快,上升瞬变的通气平均半衰期为10.9秒,下降瞬变的平均半衰期为6.6秒。在瞬变过程中,T(I)的模式与稳态时相同,而在低氧阶跃后,T(E)在阶跃后的五次呼吸内延长至远超过其最终稳态值,仅在阶跃后3 - 4分钟才恢复到其稳态值。这导致在瞬变的早期频率出现夸张的变化。

  4. 低氧环境下二氧化碳的阶跃,这是一种外周和中枢化学感受器的混合刺激,其通气反应最适合用两个指数函数拟合,其半衰期与单独反应获得的半衰期一致。模式也与混合反应一致,T(I)比T(E)更明显。

  5. 从切换前平均值得出的稳态模式与先前描述的模式一致。

  6. 讨论了可能的机制。有人认为这些结果可以解释过去使用再呼吸和稳态技术的人所看到的不同模式。

  7. 质疑使用一次或两次呼吸的氧气或氮气测试(或其他类似测试)作为人类低氧反应定量测量方法的有效性。

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本文引用的文献

1
The respiratory response to anoxaemia.对缺氧血症的呼吸反应。
J Physiol. 1919 May 20;52(6):420-32. doi: 10.1113/jphysiol.1919.sp001841.
3
Chemoreflexes in breathing.呼吸中的化学反射。
Physiol Rev. 1962 Jul;42:335-58. doi: 10.1152/physrev.1962.42.3.335.
10
On the regulation of depth and rate of breathing.论呼吸深度与频率的调节。
J Physiol. 1972 Apr;222(2):267-95. doi: 10.1113/jphysiol.1972.sp009797.

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