Vaughan T R, DeMarino E, Staub N C
Am Rev Respir Dis. 1976 Jun;113(6):757-62. doi: 10.1164/arrd.1976.113.6.757.
The indicator dilution quantity of extravascular water in the lung (idQwl) increases in exercise, but whether it is a real accumulation of fluid or is due to increased distribution of blood flow to previously unperfused regions of alveolar walls is unsettled. In 9 well-trained young men, we compared idQwl and the pulmonary capillary blood volume, as measured by the carbon monoxide diffusing capacity procedure, at rest and after 10 and about 50 min of heavy work (150 watts) on a bicycle ergometer. From rest to 10-min exercise, we observed the following changes. Heart rate 72 +/- 15 beats per min (mean +/- SD) to 151 +/- 23; cardiac output 6.0 +/- 1 liter per min to 17.7 +/- 4.1; carbon monoxide diffusing capacity, 46 +/- 10 ml per min per Hg to 65 "/- 11. These all remained constant between 10- and 50-min exercise. The idQwl increased from 178 +/- 37 ml at rest to 219 +/- 46 ml at 10 min and 233 +/- 43 ml at 50 min, and pulmonary capillary blood volume increased from 140 +/- 52 ml at rest to 220 +/- 106 and 206 +/- 98 at 10 and 50 min of exercise, respectively. All of the changes from rest to early exercise were significant (P less than 0.05) by paired t test. There were no significant changes between early and late exercise. We concluded that the early exercise increase in idQwl was due to redistribution of blood flow among and within alveolar walls. The absence of any increase in idQwl between early and late exercise is evidence against accumulation of lung fluid.
肺血管外水的指示剂稀释量(idQwl)在运动时会增加,但这究竟是液体的真正蓄积,还是由于血流重新分布到肺泡壁先前未灌注的区域,目前尚无定论。在9名训练有素的年轻男性中,我们通过一氧化碳弥散能力测定法,比较了他们在静息状态下以及在自行车测力计上进行10分钟和大约50分钟的繁重工作(150瓦)后的idQwl和肺毛细血管血容量。从静息状态到运动10分钟,我们观察到以下变化。心率从每分钟72±15次(均值±标准差)增加到151±23次;心输出量从每分钟6.0±1升增加到17.7±4.1升;一氧化碳弥散能力从每分钟每毫米汞柱46±10毫升增加到65±11毫升。在运动10分钟到50分钟之间,这些指标均保持不变。idQwl从静息时的178±37毫升增加到10分钟时的219±46毫升和50分钟时的233±43毫升,肺毛细血管血容量从静息时的140±52毫升分别增加到运动10分钟和50分钟时的220±106毫升和206±98毫升。通过配对t检验,从静息到早期运动的所有变化均具有统计学意义(P<0.05)。早期运动和晚期运动之间没有显著变化。我们得出结论,运动早期idQwl的增加是由于肺泡壁之间和内部的血流重新分布所致。早期运动和晚期运动之间idQwl没有任何增加,这证明没有肺液蓄积。