摘要
探讨高原肺心病患者吸气肌功能失调与高碳酸血症的关系。对48例高原（海拔2260～3200m）慢性肺心病缓解期患者测定了肺功能、血气、口腔最大吸气压（PImax）、最大跨膈压（Pdimax）和漏肌张力—时间指数（TTdi），并与42例当地同龄健康人对比。结果：①肺心病组PLmax、Pdimax明显低于健康组（P均＜0.01），TTdi较健康组明显延长（P＜0.01）；②将肺心病分为正常碳酸血症（A组）、轻度高碳酸血症（B组）和重度高碳酸血症（C组）。三组均有低氧血症，以C组最低，三组比较P均＜0.01。一秒种用力呼气容积（PEV1）、PImax、Pdimax均明显降低，以C组最低．三组比较P＜0．01或＜0．05。TTdi均延长，以C组最明显，三组比较P，0.01；③PaCO2与VD／VT比率和TTdi明显正相关，r值分别为0.57、0．52，P均＜0．01；与FEV1、PIamx、Pdimax明显负相关，r值分别为-0．61、－0．51、－0．58，P均＜0．01。结论：高原肺心病患者吸气肌疲劳和膈肌储备力下降在其高碳酸血症形成中起重要作用。
In order to assess relationship between inspiratory muscle dysfunction and the chronic hypercapnia in high altitude chronic cor pulninale (HACCP). The pulmonary functon. arterial blood gas, maximal inspiratory pressure (Plmax), maximal transdiaphragmatic pressure (Pdimax) and tension -time index of the diaphragmatic muscle(TTdi) were measured in 48 patients (mean aged 58. 8 yrs)with HACCP in stable stage and 42 health subjects (mean aged 56. 3 yrs) of same aged at 2 260~3 200m above sea level. Results (1)The mean PImax and Pdimax in the patients with HACCP were significantly lower and TTdi was significantly higher than those in the normal subjects(all P<0. 01). (2)The patients with HACCP were divided into 3 groups according to PaCO2 level, that is,group A with normocapnia (7 cases),group B with mild hypercapnia (18 cases) and group C with severe hypercapnia (23 cases). Mean PaO2 in group C was significantly lower than that in group A and B.the difference between the 3 groups was signifficant (all P<0. 01). The mean FEV1,PImax and Pdimx in group C were significantly lower and rate of VD/VT and TTdi were significantly higher than those in the groups A and B. The difference between the 3 groups were significant(P<0. 01 or <0. 05). (3)PaCO2 level positive correlated closely with the rate of VD/VT (r= 0. 57,P<0. 01 ) and TTdi (r= 0. 52, P<0. 01 ),whereas negalive correlated colsely with FEV, (r= - 0. 61, P<0. 01 ), Plmax (r = - 0. 51, P<0. 01 )and Pdimax (r= - 0. 58, P<0.01). The results suggest that inspiratory muscle weakness and reduction of diaphrabmatic muscle reserve in patienls with HACCP may play a very important role in developing the patients' hypercapnia.
出处
《高原医学杂志》
CAS
1997年第1期13-16,共4页
Journal of High Altitude Medicine
关键词
肺心病
呼吸肌
高原
高碳酸血症
Chronic cor pulmonale
Respiratory function lest Respiratory muscle
High altitude
