Grassi C, Serra R
Minerva Med. 1977 Sep 29;68(45):3103-16.
Physiological considerations relevant to a general understanding of the question are put forward and the main methods used for determining the ventilation-perufsion ratio are described. Over-all methods offer generic evaluation of a change, particularly the method whereby the alveolus/arterial PO2 gradient is measured on straight lines expressing the different points of gas and blood respiratory exchanges, and that which measures the triple CO2, O2 and N2 alveolus/arterial gradient. Methods employed to evaluate the distribution of ratio changes are also explained: evaluation with CO2 labelled with 15O2, 133Xe, 13N2 and 85Kr, using pairs of scintillators, scanning detectors, gamma camera or special cuvettes, and analysis of respiratory He, Ar, O2, CO2, N2O and CHF2Cl at the mouth and inside the lung, using rapid analysers and single or multiple breath methods, or analysis of gas elimination coefficients. It is felt that measurement of the VA:Qc ratio is now within the capacity of all laboratories, so that qualitative, semi-quantitative and quantitative assessment can be made not only of the ability to ensure efficient alveolar exchange on the part of ventilation and circumation, but also of the presence of compensated changes, or the simultaneous presence of other alterations of various kinds, which cannot be readily detected by using conventional methods.
提出了与全面理解该问题相关的生理学考量,并描述了用于测定通气/灌注比的主要方法。整体方法可对变化进行一般评估,特别是通过在表示气体和血液呼吸交换不同点的直线上测量肺泡/动脉血氧分压梯度的方法,以及测量二氧化碳、氧气和氮气的三重肺泡/动脉梯度的方法。还解释了用于评估比值变化分布的方法:使用15O2、133Xe、13N2和85Kr标记的二氧化碳,借助成对闪烁器、扫描探测器、伽马相机或特殊比色皿进行评估,以及使用快速分析仪和单次或多次呼吸法,或分析气体消除系数,对口腔和肺内的呼吸氦气、氩气、氧气、二氧化碳、一氧化二氮和二氯二氟甲烷进行分析。人们认为,现在所有实验室都有能力测量VA:Qc比值,因此不仅可以对通气和循环确保有效肺泡交换的能力进行定性、半定量和定量评估,还可以对代偿性变化的存在,或同时存在的其他各种不易用传统方法检测到的改变进行评估。