慢性心肌衰竭患者在静息、运动及肼屈嗪治疗后时的动脉氧合及动脉氧输送情况。

Arterial oxygenation and arterial oxygen transport in chronic myocardial failure at rest, during exercise and after hydralazine treatment.

作者信息

Rubin S A, Brown H V, Swan H J

出版信息

Circulation. 1982 Jul;66(1):143-8. doi: 10.1161/01.cir.66.1.143.

DOI:10.1161/01.cir.66.1.143

Abstract

Arterial oxygen transport (cardiac output x arterial oxygen content) may be decreased in heart failure. We studied the determinants of arterial oxygen transport in 15 patients with chronic, severe myocardial failure at rest and during cycle ergometry. During control therapy at rest, arterial oxygen tension was normal (81 +/- 8 mm Hg, mean +/- SD) and increased slightly during exercise (90 +/- 14 mm Hg). During hydralazine therapy at rest, arterial oxygen tension was slightly higher (87 +/- 9 mm Hg) and also increased during exercise (92 +/- 15 mm Hg). Hydralazine did not increase arterial oxygen tension (0.10 greater than p greater than 0.05), but exercise did (p less than 0.02). Arterial oxygen saturation and content were normal and did not change under any condition or treatment. During control therapy at rest, arterial oxygen transport was low (313 +/- 74 ml/min . m2) and remained abnormally low during exercise (434 +/- 124 ml/min . m2). During hydralazine therapy, arterial oxygen transport was higher at rest (457 +/- 100 ml/min . m2) and during exercise (577 +/- 131 ml/min . m2). Hydralazine increased arterial oxygen transport (p less than 0.01) because it increased stroke volume at rest and during exercise, but it did not change arterial oxygenation. Arterial oxygenation is normal in chronic heart failure patients at rest and during exercise. Hydralazine increases cardiac output and arterial oxygen transport without changing arterial oxygenation.

摘要

心力衰竭时动脉氧运输量（心输出量×动脉血氧含量）可能会降低。我们研究了15例慢性重度心肌衰竭患者在静息状态和进行蹬车运动时动脉氧运输的决定因素。在静息状态下接受常规治疗时，动脉血氧分压正常（81±8 mmHg，均值±标准差），运动时略有升高（90±14 mmHg）。在静息状态下接受肼屈嗪治疗时，动脉血氧分压略高（87±9 mmHg），运动时也升高（92±15 mmHg）。肼屈嗪未使动脉血氧分压升高（0.10＞p＞0.05），但运动使其升高（p＜0.02）。动脉血氧饱和度和含量正常，在任何情况或治疗下均未改变。在静息状态下接受常规治疗时，动脉氧运输量较低（313±74 ml/min·m²），运动时仍异常低（434±124 ml/min·m²）。在接受肼屈嗪治疗时，静息和运动时动脉氧运输量均较高（静息时457±100 ml/min·m²，运动时577±131 ml/min·m²）。肼屈嗪增加了动脉氧运输量（p＜0.01），因为它增加了静息和运动时的每搏输出量，但未改变动脉氧合情况。慢性心力衰竭患者在静息和运动时动脉氧合正常。肼屈嗪增加心输出量和动脉氧运输量，而不改变动脉氧合情况。