Jubran A, Grant B J, Tobin M J
The Division of Pulmonary and Critical Care Medicine, Edward Hines Jr. Veterans Administration Hospital and Loyola University of Chicago Stritch School of Medicine, Hines, Illinois 60141, USA.
Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1129-39. doi: 10.1164/ajrccm.156.4.97-01080.
Dysrhythmias of breathing occur in several clinical disorders, but their mechanistic basis is obscure. To understand their pathophysiology, factors responsible for the variability of breathing need to be defined. We studied the effect of hyperoxic hypercapnia (CO2) on the variational activity of breathing in 14 volunteers before and after delivering CO2 nonobstrusively via a plastic hood. Compared with air, CO2 increased the gross variability of minute ventilation (VI) and tidal volume (VT), and decreased that of inspiratory time (TI) and expiratory time (TE) (all p < 0.03). CO2 increased the autocorrelation coefficient at a lag of one breath for VI (p < 0.05), the number of consecutive breath lags having significant autocorrelation coefficients for VI and VT (both p < 0.01), and the cycle time of oscillations in VI (p = 0.03) and VT (p = 0.04). Uncorrelated random behavior constituted > or = 80% of the variance of each breath component, correlated behavior represented 9 to 20%, and oscillatory behavior represented < 1% during both air and CO2. CO2 increased the correlated behavior of volume components, which was accompanied by development of low-frequency oscillations with a cycle time consistent with central chemoreceptor activation.
呼吸节律失常见于多种临床疾病,但其机制尚不清楚。为了解其病理生理学,需要明确导致呼吸变异性的因素。我们在14名志愿者通过塑料面罩无创给予二氧化碳前后,研究了高氧高碳酸血症(CO2)对呼吸变异性活动的影响。与空气相比,CO2增加了分钟通气量(VI)和潮气量(VT)的总体变异性,并降低了吸气时间(TI)和呼气时间(TE)的变异性(所有p<0.03)。CO2增加了VI在一个呼吸周期延迟时的自相关系数(p<0.05),增加了VI和VT具有显著自相关系数的连续呼吸周期延迟次数(均p<0.01),以及VI(p = 0.03)和VT(p = 0.04)振荡的周期时间。在空气和CO2条件下,不相关随机行为占每个呼吸成分方差的≥80%,相关行为占9%至20%,振荡行为占<1%。CO2增加了容积成分的相关行为,同时伴随着与中枢化学感受器激活一致的周期时间的低频振荡的出现。