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低氧性通气抑制期间的代谢与酸碱状态

Metabolism and acid-base status during hypoxic ventilatory depression.

作者信息

Sudo T, Fukuda Y

机构信息

Department of Physiology II, School of Medicine, Chiba University, Chuoh-ku, Chiba, 260 Japan.

出版信息

Jpn J Physiol. 1997 Dec;47(6):531-6. doi: 10.2170/jjphysiol.47.531.

DOI:10.2170/jjphysiol.47.531
PMID:9538277
Abstract

The ventilatory response to acute systemic hypoxia has been thought to be determined by the balance between hypoxic stimulation via peripheral chemoreceptors and hypoxic inhibition of the respiratory neurons. In moderate-severe hypoxia, the latter predominates the former resulting in ventilatory "depression" (HVD). However, ventilation relative to metabolic rate (V.O2) during HVD is "not depressed" but remains increased because of associated reduction in O2 uptake (V.O2). The experiment presented here was conducted to elucidate the changes in CO2 output (V.CO2) and acid-base status during hypoxia and their role in ventilatory regulation. Ventilation, metabolic rate (V.O2, V.CO2), acid-base status and blood lactate concentration were measured during and after inhalation of hypoxic gases in halothane-anesthetized and spontaneously breathing rats. The HVD occurred at FIO2 0.08 with increased blood lactate concentration, increased venous PCO2 and a large drop in venous pH without significant changes in arterial pH and PCO2. Furthermore, the amount of reduction in V.CO2 during HVD was much smaller than that of V.O2 and the V.CO2/V.O2 ratio increased. These findings suggest that CO2 output becomes relatively higher than O2 consumption in moderate-severe hypoxia. The possible origin of CO2 accumulation in the venous blood, such as the buffering of lactic acid by bicarbonate, and its role in ventilatory stimulation are discussed. Since there was no large increase in V.E and metabolic rate in the post-hypoxic period, "O2 debt" during HVD was small.

摘要

急性全身性缺氧时的通气反应被认为取决于外周化学感受器的缺氧刺激与呼吸神经元的缺氧抑制之间的平衡。在中重度缺氧时,后者占主导地位,导致通气“抑制”(HVD)。然而,在HVD期间,相对于代谢率(V.O2)的通气“并未受到抑制”,而是由于O2摄取量(V.O2)的相应减少而保持增加。本文进行的实验旨在阐明缺氧期间二氧化碳排出量(V.CO2)和酸碱状态的变化及其在通气调节中的作用。在氟烷麻醉且自主呼吸的大鼠吸入缺氧气体期间及之后,测量其通气、代谢率(V.O2、V.CO2)、酸碱状态和血乳酸浓度。HVD发生于FIO2为0.08时,此时血乳酸浓度升高、静脉血PCO2升高且静脉血pH大幅下降,而动脉血pH和PCO2无显著变化。此外,HVD期间V.CO2的减少量远小于V.O2的减少量,且V.CO2/V.O2比值增加。这些发现表明,在中重度缺氧时,二氧化碳排出量相对于氧气消耗量变得相对更高。文中讨论了静脉血中二氧化碳蓄积的可能来源,如乳酸被碳酸氢盐缓冲,以及其在通气刺激中的作用。由于缺氧后时期V.E和代谢率没有大幅增加,HVD期间的“氧债”较小。

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