Chin K, Hirai M, Kuriyama T, Kita H, Nakamura T, Shimizu K, Kuno K, Ohi M
Department of Clinical Physiology, Kyoto University, Japan.
QJM. 1997 Jul;90(7):477-85. doi: 10.1093/qjmed/90.7.477.
We assessed 12 patients with hyperventilation syndrome (HVS) who had experienced hypoxaemia (PaO2 < 60 Torr or SaO2 < 90%) despite the lack of any other organic disease and variability in their blood gas data. Hypoxic and hypercapnic ventilatory responses were measured in nine. Eight of the 12 patients had been referred from other hospitals to our institution for hypoxaemia of unknown origin. Mean PaO2 (n = 12) at rest (non-attack stage) was 87.3 +/- 7.5 Torr (mean +/- SD). Their (n = 9) hypoxic (-0.53 +/- 0.32 l/min/%; range 0.12-0.99) and hypercapnic (2.01 +/- 0.76 l/min/Torr; range 0.69-3.17) ventilatory responses were both within the normal range in our laboratory. The patients with HVS had variable blood gas data, and some of them also exhibited hypercapnia (PaCO2 > 45 Torr). Clinicians who treat patients with HVS should be aware of the possibility of hypoxaemia, even when ventilatory responses are normal. Physicians should also consider HVS as a diagnosis when treating patients with hypoxaemia of unknown origin.
我们评估了12例患有通气过度综合征(HVS)的患者,这些患者尽管没有任何其他器质性疾病,但仍出现了低氧血症(动脉血氧分压<60托或动脉血氧饱和度<90%),且其血气数据存在变异性。对其中9例患者测量了低氧和高碳酸通气反应。12例患者中有8例因不明原因的低氧血症从其他医院转诊至我院。静息状态(非发作期)时的平均动脉血氧分压(n = 12)为87.3±7.5托(平均值±标准差)。他们(n = 9)的低氧通气反应(-0.53±0.32升/分钟/%;范围0.12 - 0.99)和高碳酸通气反应(2.01±0.76升/分钟/托;范围0.69 - 3.17)在我们实验室均处于正常范围内。患有通气过度综合征的患者血气数据存在变异性,其中一些患者还表现出高碳酸血症(动脉血二氧化碳分压>45托)。治疗通气过度综合征患者的临床医生应意识到即使通气反应正常也可能存在低氧血症。在治疗不明原因低氧血症的患者时,医生也应考虑通气过度综合征作为一种诊断。