代谢、血液碱化和纯氧影响呼吸调控的人体实验研究Ⅲ:血液碱化后纯氧运动试验

发布时间：2018-04-13 01:29

本文选题：碱化血液 + 吸入纯氧　；参考：《中国应用生理学杂志》2015年04期

【摘要】：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(P0.05);仅静息每分通气量较血液碱化空气CPET略高(P0.05),而其它状态和恢复2min时均相近(P0.05)。潮气量仅峰值运动时较对照和血液碱化空气CPET略低(P0.05);而运动过程和恢复2min时的潮气量均相近(P0.05)。呼吸频率在各个时间与血液碱化前后CPET均无差异(P0.05)。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(P0.001,P0.05)。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(P0.05),比血液碱化后差异不显著(P0.05);开始时的Pa CO2较碱化血液前后空气CPET时降低(P0.05),无氧阈时相近(P0.05),但到峰值及恢复2 min时明显增高(P0.05);p H仅较对照增高(P0.05),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(P0.05)。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。
[Abstract]:Objective: to investigate the effects of inhaled pure oxygen on respiratory regulation on the basis of CPETs before and after air inhalation.Methods: five normal volunteers who breathed pure oxygen CPETs after alkalization of blood were measured continuously during rest warm-up exercise and convalescence. The blood gas indexes of each minute arterial sampling were measured continuously.The dynamic changes of respiratory gas exchange and blood gas index during CPET were analyzed and compared with CPET data before and after acute alkalization of blood.Results: the respiratory response of air CPET after inhalation of pure oxygen after alkaline blood was basically the same as that before acute alkalization of blood and during the period of CPET.The ventilation volume per minute in each exercise state was similar to that in the control group, but the resting ventilation volume was slightly higher than that in the blood alkaline air CPET, while the other states and the recovery of 2min were similar to that of the control group.The tidal volume was only slightly lower than that of the control and blood alkaline air (CPET) at the peak movement, while the tidal volume during the exercise and the recovery of 2min was similar to that of the control.There was no difference in respiratory frequency between CPET and blood before and after alkalization (P 0.05).Compared with the air CPET before and after the alkalization of blood, the P0.001 and P0.05 of PAO 2 and SAO 2 in every period of exercise were significantly higher than those before and after the alkalization of blood.Although the hemoglobin concentration was lower than that before and after acute blood alkalization,The control group increased P0.05, but there was no difference between the control group and the alkaline blood air test.The level of lactic acid was slightly higher than that of the control, but the difference was only in the warm-up and convalescence period (P 0.05).Pure oxygen increases the power and time of two-person anaerobic threshold and three-person peak motion.Conclusion: although the respiratory response of blood treated with pure oxygen is similar to that before the alkalization of blood, the air CPET respiratory response pattern is similar after exercise, which indicates that the respiratory response during exercise is mainly dependent on metabolic changes, not on the mean value of arterial blood gas.
【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管疾病国家重点实验室心血管病国家临床医学研究中心;美国加州大学洛杉矶分校Harbor-UCLA医学中心洛杉矶生物医学研究院圣约翰心血管研究中心;河北医科大学第四人民医院功能科;山东省潍坊医学院麻醉学系临床麻醉学教研室和临床医学系;广州市第一人民医院麻醉科;
【基金】：国家自然科学基金医学科学部面上项目(81470204) 国家高新技术研究发展计划(863计划)课题(2012AA021009) 中国医学科学院国家心血管病中心科研开发启动基金(2012-YJR02)
【分类号】：R33

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