Brimioulle S, LeJeune P, Naeije R
Laboratory of Cardiovascular and Respiratory Physiology, Free University of Brussels, Belgium.
J Appl Physiol (1985). 1996 Oct;81(4):1535-43. doi: 10.1152/jappl.1996.81.4.1535.
Several reports have suggested that hypoxic pulmonary vasoconstriction (HPV) might result in deterioration of pulmonary gas exchange in severe hypoxia. We therefore investigated the effects of HPV on gas exchange in normal and diseased lungs. We incorporated a biphasic HPV stimulus-response curve observed in intact dogs (S. Brimioulle, and R. Lejeune, J.L. Vachièry, M. Delcroix, R. Hallemans, and R. Naeije, J. Appl. Physiol. 77: 476-480, 1994) into a 50-compartment lung model (J.B. West, Respir. Physiol. 7: 88-110, 1969) to control the amount of blood flow directed to each lung compartment according to the local hypoxic stimulus. The resulting model accurately reproduced the blood gas modifications caused by HPV changes in dogs with acute lung injury. In single lung units, HPV had a moderate protective effect on alveolar oxygenation, which was maximal at near-normal alveolar PO2 (75-80 Torr), mixed venous PO2 (35 Torr), and PO2 at which hemoglobin is 50% saturated (24 Torr). In simulated diseased lungs associated with 40-60 Torr arterial PO2, however, HPV increased arterial PO2 by 15-20 Torr. We conclude that HPV can improve arterial oxygenation substantially in respiratory failure.
几份报告表明，低氧性肺血管收缩（HPV）可能会导致严重低氧情况下肺气体交换恶化。因此，我们研究了HPV对正常肺和患病肺气体交换的影响。我们将在完整犬类中观察到的双相HPV刺激-反应曲线（S. Brimioulle、R. Lejeune、J.L. Vachièry、M. Delcroix、R. Hallemans和R. Naeije，《应用生理学杂志》77: 476 - 480，1994年）纳入一个50房室肺模型（J.B. West，《呼吸生理学》7: 88 - 110，1969年），以便根据局部低氧刺激来控制流向每个肺房室的血流量。所得模型准确再现了急性肺损伤犬类中HPV变化引起的血气改变。在单个肺单位中，HPV对肺泡氧合有适度的保护作用，在接近正常的肺泡氧分压（75 - 80托）、混合静脉氧分压（35托）以及血红蛋白饱和度为50%时的氧分压（24托）下，这种保护作用最大。然而，在模拟动脉氧分压为40 - 60托的患病肺中，HPV使动脉氧分压提高了15 - 20托。我们得出结论，在呼吸衰竭中，HPV可显著改善动脉氧合。
