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[慢性心力衰竭中的潮式呼吸]

[Cheyne-Stokes respiration in chronic heart insufficiency].

作者信息

Bühlmann A A, Neuenschwander R

出版信息

Schweiz Med Wochenschr. 1977 Jun 11;107(23):802-7.

PMID:877530
Abstract

1.26 of 340 patients with chronic heart failure (aortic-valve or mitral-valve disease, congestive cardiomyopathy) showed Cheyne-Stokes respiration in supine position. 2. The incidence of Cheyne-Stokes respiration in males is more than twice as high as in females with similar hemodynamic conditions. 3. Lung volumes and airway resistance did not appreciably deviate from the predicted values and are therefore of no etiologic significance. 4. Delay of the feedback between changes in the alveolar gas tensions and respiratory center caused by a prolonged circulation time (decreased cardiac index and increased central blood volume) is the predominant cause of Cheyne-Stokes breathing in patients with chronic heart failure. 5. Metabolic alkalosis (e.g. after diuretics) favors Cheyne-Stokes respiration in patients with congestive heart failure and low cardiac output, by lessening respiratory changes in pH of blood and cerebrospinal fluid.

摘要
  1. 在340例慢性心力衰竭(主动脉瓣或二尖瓣疾病、充血性心肌病)患者中,1.26%的患者在仰卧位时出现潮式呼吸。2. 在血流动力学状况相似的情况下,男性潮式呼吸的发生率是女性的两倍多。3. 肺容量和气道阻力与预测值无明显偏差,因此无病因学意义。4. 循环时间延长(心脏指数降低和中心血容量增加)导致肺泡气体张力变化与呼吸中枢之间的反馈延迟,是慢性心力衰竭患者发生潮式呼吸的主要原因。5. 代谢性碱中毒(如使用利尿剂后)通过减少血液和脑脊液pH值的呼吸变化,有利于充血性心力衰竭和心输出量低的患者出现潮式呼吸。

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