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特发性脊柱侧弯呼吸的中枢调节(作者译)

[Central regulation of breathing in idiopathic scoliosis (author's transl)].

作者信息

Lack W, Haber P, Lukeschitsch G, Kummer F

出版信息

Acta Med Austriaca. 1981;8(5):145-9.

PMID:6800207
Abstract

Idiopathic scoliosis is in nearly 80% associated with an EEG deviating from a normal pattern. Therefore a possible cerebral dysfunction as one of the etiologic factors in the development of idiopathic scoliosis is discussed. In consequence, we studied the central respiratory regulation in 26 patients with idiopathic scoliosis by means of CO2 response with the CO2 rebreathing technique, also vital capacity (VC), maximal voluntary ventilation (MVV), respiratory minute volume at 50, 60 and 70 mm Hg arterial pCO2 and EEG. The CO2-index (1/min/mm Hg CO2) was significantly lower in patients with idiopathic scoliosis (0.92 +/- 0.43) than in normals (1.5 +/- 0.3). The decrease of CO2-index is mainly associated with the smaller VC of the patients (76 +/- 26% of predicted). There is no sign of an additional influence of cerebral dysfunction. Patients with idiopathic scoliosis are able to utilize 70% of the individual breathing reserve like normals when stimulated with CO2. The EEG and the VC show a negative correlation. This may possibly be due to a compensation of the preexisting cerebral dysfunction. VC however decreases during the natural course of disease. No significant correlation could be found between CO2-index and the angle of scoliosis, indicating the absence of a causal relation between the degree of deformation itself and the function of the center of respiratory regulation.

摘要

特发性脊柱侧弯近80%与脑电图偏离正常模式有关。因此,人们讨论了可能存在的脑功能障碍作为特发性脊柱侧弯发病的病因之一。为此,我们采用二氧化碳再呼吸技术通过二氧化碳反应对26例特发性脊柱侧弯患者的中枢呼吸调节进行了研究,并测量了肺活量(VC)、最大自主通气量(MVV)、动脉血二氧化碳分压为50、60和70 mmHg时的呼吸分钟量以及脑电图。特发性脊柱侧弯患者的二氧化碳指数(1/分钟/mmHg二氧化碳)(0.92±0.43)显著低于正常人(1.5±0.3)。二氧化碳指数的降低主要与患者较小的肺活量有关(为预测值的76±26%)。没有迹象表明存在脑功能障碍的额外影响。特发性脊柱侧弯患者在受到二氧化碳刺激时,能够像正常人一样利用个体呼吸储备的70%。脑电图与肺活量呈负相关。这可能是由于对先前存在的脑功能障碍的一种代偿。然而,肺活量在疾病的自然进程中会下降。在二氧化碳指数与脊柱侧弯角度之间未发现显著相关性,这表明变形程度本身与呼吸调节中枢功能之间不存在因果关系。

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