Garrard C S, Lane D J
Thorax. 1981 Feb;36(2):130-4. doi: 10.1136/thx.36.2.130.
The pattern of stimulated breathing during carbon dioxide inhalation was studied in a group of 21 patients with severe irreversible airways obstruction (mean FEV1 = 0.9 litre, mean FEV1/FVC% = 50%). Carbon dioxide rebreathing experiments were performed, the ventilatory response being defined in terms of total ventilation (V) and CO2 sensitivity (S). Breathing pattern was defined by the changes in tidal volume (delta VT) and respiratory frequency (delta f) and the maximum VT achieved (VTmax). Contrary to some previous studied no significant relationship could be demonstrated between the severity of airway obstruction (FEV1/FVC%, Raw) and the ventilatory response to rebreathing (V, S, delta VT, delta f, VTmax). However, measurements of dynamic lung volume (FEV1, FVC, IC) were found to be significantly correlated with the breathing pattern variables (delta VT, delta f, VTmax). Resting PaO2 and PaCO2 were significantly correlated with delta VT but not delta f. Results indicate that the degree of airway obstruction does not dictate the ventilatory or breathing pattern response to carbon dioxide induced hyperpnoea. In contrast it is the restriction of dynamic lung volume, by limiting the VT response, that appears to determine the ventilatory and breathing pattern response in patients with severe airway obstruction.
对一组21例严重不可逆性气道阻塞患者（平均第一秒用力呼气容积[FEV1]=0.9升，平均FEV1/用力肺活量[FVC]%=50%）在吸入二氧化碳期间的呼吸激发模式进行了研究。进行了二氧化碳重复呼吸实验，通气反应以总通气量（V）和二氧化碳敏感性（S）来定义。呼吸模式由潮气量变化（δVT）、呼吸频率变化（δf）以及达到的最大潮气量（VTmax）来定义。与之前的一些研究相反，气道阻塞的严重程度（FEV1/FVC%、气道阻力）与重复呼吸的通气反应（V、S、δVT、δf、VTmax）之间未显示出显著相关性。然而，发现动态肺容积测量值（FEV1、FVC、肺活量[IC]）与呼吸模式变量（δVT、δf、VTmax）显著相关。静息动脉血氧分压（PaO2）和动脉血二氧化碳分压（PaCO2）与δVT显著相关，但与δf不相关。结果表明，气道阻塞程度并不决定对二氧化碳诱发的通气过度的通气或呼吸模式反应。相反，似乎是动态肺容积的限制，通过限制潮气量反应，决定了严重气道阻塞患者的通气和呼吸模式反应。
