Lampert-Benignus E, Meunier-Carus J, Metz B
Poumon Coeur. 1981;37(3):187-93.
With the aim of determining the causes of hypoxia which develops on effort in certain emphysema sufferers, gas exchange at rest and effort were studied in 28 patients with diffuse pulmonary emphysema (including one third with large bullous form), with the exclusion of any clinical evidence of bronchitis or asthma. These patients, selected on the basis of the similarity of their clinical, radiological, mechano-spirographic and diffusion criteria, behaved very differently in terms of their gas exchanges during a moderate effort (mean VO2 = 750 ml/mn). The first group of 12 subjects showed a significant fall in pO2 (- 10.5 mmHg on average). The second group of 16 subjects improved by 4 mmHg hypoxaemia present at rest (though more marked than in the first group). The various parameters studied of ventilation, blood gases, and diffusion appeared to indicate a preponderant role played by distributive problems, and in particular the Qs/Qt ratio (calculated on the Fenn and Rahn pO2 and pCO2 diagram) which worsened on effort in the first group whilst it improved in the second, as well as the greater degree of desaturation of mixed venous blood on effort in the first group. The difficulties of a valid physiopathological interpretation are emphasized.
为了确定某些肺气肿患者运动时出现缺氧的原因，我们对28例弥漫性肺气肿患者（其中三分之一为大疱型）的静息和运动时的气体交换进行了研究，排除了任何支气管炎或哮喘的临床证据。这些患者根据其临床、放射学、机械通气和弥散标准的相似性进行选择，在中等强度运动（平均VO2 = 750 ml/分钟）期间，他们的气体交换表现差异很大。第一组12名受试者的pO2显著下降（平均下降10.5 mmHg）。第二组16名受试者静息时存在的低氧血症改善了4 mmHg（尽管比第一组更明显）。所研究的通气、血气和弥散的各种参数似乎表明分布问题起主要作用，特别是Qs/Qt比值（根据芬恩和拉恩的pO2和pCO2图计算），第一组运动时恶化，而第二组运动时改善，以及第一组运动时混合静脉血的去饱和程度更高。强调了进行有效生理病理学解释的困难。
