Peterson D D, Pack A I, Silage D A, Fishman A P
Am Rev Respir Dis. 1981 Oct;124(4):387-91. doi: 10.1164/arrd.1981.124.4.387.
Studies were performed to examine the decrease in ventilatory response to hypoxia and hypercapnia in the elderly and to explore its etiology. For this purpose, matched groups of normal elderly (65 to 79 yr of age) and young subjects were used. Standard pulmonary function tests were supplemented in both groups by determination of total respiratory compliance and the ventilatory responses to hyperoxic hypercapnia and isocapnic hypoxia using rebreathing methods. While testing the ventilatory responses, we recorded minute ventilation and its components, as well as mouth occlusion pressures, and rib cage and abdominal-diaphragmatic compartmental ventilation (magnetometry). We found that ventilatory responses to both hypercapnia and hypoxia were reduced in the elderly by approximately 50%. These reductions were not related to any change in control of respiratory timing, but to a large reduction in mean inspiratory airflow. The reduced airflow could not be attributed to alterations in pulmonary mechanics since the differences in mechanics between the groups were small. Instead, since the occlusion pressure responses to hypercapnia and hypoxia were reduced in the elderly proportionately to the ventilatory responses, reduction in neuromuscular inspiratory output was likely to be the major factor.
开展了多项研究,以检测老年人对低氧和高碳酸血症的通气反应降低情况,并探究其病因。为此,使用了年龄匹配的正常老年人(65至79岁)和年轻受试者组。通过测定总呼吸顺应性以及采用重复呼吸法测定对高氧高碳酸血症和等碳酸低氧血症的通气反应,对两组进行了标准肺功能测试。在测试通气反应时,我们记录了分钟通气量及其组成部分、口腔闭塞压以及胸廓和腹膈部通气(磁力测定法)。我们发现,老年人对高碳酸血症和低氧血症的通气反应均降低了约50%。这些降低与呼吸时间控制的任何变化无关,而是与平均吸气气流大幅降低有关。气流降低不能归因于肺力学改变,因为两组之间的力学差异很小。相反,由于老年人对高碳酸血症和低氧血症的闭塞压反应与通气反应成比例降低,神经肌肉吸气输出降低可能是主要因素。