论文部分内容阅读
目的:在急性血液碱化前、后空气吸入下完成症状限制性最大极限心肺运动试验(CPET)的基础上,本文探讨在血液碱化后吸入纯氧对呼吸调控的影响。方法:正常志愿者5名在碱化血液后呼吸纯氧CPET,在静息、热身、运动及恢复期,连续测定肺通换气指标及每分钟动脉取样的血气指标,对CPET期间的呼吸气体交换和血气指标的动态变化进行分析,同时与急性碱化血液前、后空气CPET数据比较。结果:碱化血液后吸入纯氧运动呼吸反应与急性碱化血液前、后空气CPET呼吸反应基本一致。CPET期间,各运动状态下的每分通气量均与对照组相似(P>0.05);仅静息每分通气量较血液碱化空气CPET略高(P<0.05),而其它状态和恢复2min时均相近(P>0.05)。潮气量仅峰值运动时较对照和血液碱化空气CPET略低(P<0.05);而运动过程和恢复2min时的潮气量均相近(P>0.05)。呼吸频率在各个时间与血液碱化前后CPET均无差异(P>0.05)。在碱化血液后吸入纯氧运动各个时期的Pa O2和Sa O2较碱化血液前后空气CPET时明显提高(P<0.001,P<0.05)。血红蛋白浓度虽然较急性血液碱化前后均低,但仅较血液碱化前显著降低(P<0.05),比血液碱化后差异不显著(P>0.05);开始时的Pa CO2较碱化血液前后空气CPET时降低(P<0.05),无氧阈时相近(P>0.05),但到峰值及恢复2 min时明显增高(P<0.05);p H仅较对照增高(P<0.05),但与碱化血液空气试验时无差异;乳酸水平较对照略高,但仅在热身和恢复期有差异(P<0.05)。纯氧提高了两人无氧阈和三人峰值运动的功率和时间。结论:虽然血液碱化给予纯氧,CPET呼吸反应与碱化血液前、后空气CPET呼吸反应模式相似,表明运动中呼吸反应主要取决于代谢变化,而非动脉血气平均值高低。
OBJECTIVE: To investigate the effect of inhalation of pure oxygen on respiratory regulation after blood alkalinization based on the maximum limit cardiopulmonary exercise test (CPET) under acute inhalation of air before and after acute blood alkalosis. Methods: Five normal volunteers were exposed to pure oxygen CPET after alkalinization of blood. During rest, warm-up, exercise and convalescence, continuous measurement of pulmonary ventilation index and arterial blood gas sampling per minute, CPET during respiratory gas Exchange and blood gas indicators of dynamic changes were analyzed at the same time with acute alkalosis blood before and after CPET data comparison. Results: The respiratory reaction of pure oxygen inhalation after basified blood was basically the same as that of CPET before and after acute alkalosis. During CPET, the minute ventilation in each exercise condition was similar to that in the control group (P> 0.05); only the resting ventilation was slightly higher than CPET (P <0.05), while the other conditions were restored 2 minutes When are similar (P> 0.05). Tidal volume was only slightly lower than that of control and blood alkalinizing air (P <0.05) at peak exercise, while tidal volume was similar at 2 min after exercise (P> 0.05). Respiratory rate at all times and before and after basal blood CPET showed no difference (P> 0.05). Pa O2 and Sa O2 inhaled pure oxygen in all periods after alkalinization of blood were significantly higher than those before and after basified air CPET (P <0.001, P <0.05). Although hemoglobin concentration before and after acute blood alkalization were low, but only significantly lower than the blood before alkalinization (P <0.05), compared with blood alkalin after the difference was not significant (P> 0.05); Pa CO2 at the beginning of the more alkaline blood Air CPET decreased (P <0.05) and anaerobic threshold (P> 0.05), but peaked at 2 min and recovered significantly (P <0.05) However, there was no difference with the alkalinized blood air test. The level of lactate was slightly higher than that of the control group, but only difference between warm-up and recovery (P <0.05). Pure oxygen increased both the anaerobic threshold and the peak power of the three-person exercise and the time. CONCLUSIONS: Although the blood alkalinization gives pure oxygen, CPET respiration reaction is similar to the respiratory CPET before and after alkalinization, indicating that the respiratory response during exercise mainly depends on the metabolic changes, but not the mean value of non-arterial blood gas.