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衰老对呼吸负荷代偿及呼吸困难感觉的影响。

Effects of aging on respiratory load compensation and dyspnea sensation.

作者信息

Akiyama Y, Nishimura M, Kobayashi S, Yamamoto M, Miyamoto K, Kawakami Y

机构信息

First Department of Medicine, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Am Rev Respir Dis. 1993 Dec;148(6 Pt 1):1586-91. doi: 10.1164/ajrccm/148.6_Pt_1.1586.

Abstract

To clarify effects of aging on the load compensation response and the sensation of dyspnea, we examined 28 healthy male volunteers for ventilatory and P0.1 responses to hyperoxic progressive hypercapnia with and without inspiratory flow-resistive loading (17 cm H2O/L/s) while the intensity of dyspnea was simultaneously assessed by visual analogue scaling every 15 s. Of the 28 subjects, 14 were 61 to 79 yr of age and were classified as the older group; the others, 19 to 48 yr of age, were classified as the control group. Neither delta VE/delta PETCO2 nor delta P0.1/delta PETCO2 was different between the two groups without loading. In the control group, the delta P0.1/delta PETCO2 increased with loading (p < 0.01) without a change in the delta VE/delta PETCO2. In the older group, the delta P0.1/delta PETCO2 did not change with loading so that the delta VE/delta PETCO2 decreased with loading (p < 0.01). In the 28 subjects as a whole, the percent change in delta P0.1/delta PETCO2 with loading was inversely correlated with age (r = -0.53, p < 0.01). At PETCO2 levels of 45, 50, and 55 mm Hg, irrespective of loading, the dyspnea intensity was greater in the older group than in the control group, whereas the P0.1 expressed as its ratio to the predicted maximal inspiratory mouth pressure was not different between the two groups. We conclude that aging attenuates the compensatory response to inspiratory flow-resistive loading and it increases the intensity of dyspnea for a given level of PETCO2.

摘要

为阐明衰老对负荷补偿反应及呼吸困难感觉的影响,我们对28名健康男性志愿者进行了研究,观察他们在有和没有吸气气流阻力负荷(17 cm H₂O/L/s)情况下,对高氧性渐进性高碳酸血症的通气和P₀.₁反应,同时每15秒通过视觉模拟评分法评估呼吸困难的强度。在这28名受试者中,14名年龄在61至79岁,被归为老年组;其他19至48岁的受试者被归为对照组。在无负荷情况下,两组的ΔVE/ΔPETCO₂和ΔP₀.₁/ΔPETCO₂均无差异。在对照组中,ΔP₀.₁/ΔPETCO₂随负荷增加(p < 0.01),而ΔVE/ΔPETCO₂无变化。在老年组中,ΔP₀.₁/ΔPETCO₂不随负荷改变,因此ΔVE/ΔPETCO₂随负荷降低(p < 0.01)。在全体28名受试者中,ΔP₀.₁/ΔPETCO₂随负荷的百分比变化与年龄呈负相关(r = -0.53,p < 0.01)。在PETCO₂水平为45、50和55 mmHg时,无论有无负荷,老年组的呼吸困难强度均大于对照组,而以其与预测最大吸气口腔压力的比值表示的P₀.₁在两组之间无差异。我们得出结论,衰老减弱了对吸气气流阻力负荷的代偿反应,并在给定的PETCO₂水平下增加了呼吸困难的强度。

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