The pathophysiology of hyperventilation syndrome.
The pathophysiology of hyperventilation syndrome.
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过度通气综合征的病理生理学。
DOI：
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发表时间：
1999
期刊：
影响因子：
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通讯作者：
H. Folgering
中科院分区：
文献类型：
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作者：
H. Folgering
过度换气被定义为呼吸超过身体的代谢需要，消除比产生的更多的二氧化碳，并因此导致呼吸暂停和血液pH升高。过度换气综合征的传统定义描述了“一种综合征，其特征在于由生理上不适当的过度换气引起的各种躯体症状，通常由自愿过度换气再现”。过度换气综合征的症状谱非常广泛，无特异性且变化多样。它们实际上来自于每一个管道，并且可以由生理机制引起，例如低Pa、CO2或交感肾上腺素能张力增加。心理机制也有助于神经病学，甚至产生一些症状。以过度通气综合征的传统定义为出发点，诊断标准应该有三个要素：1）患者应过度通气且具有低Pa、CO 2，2）应排除引起过度通气的躯体疾病，3）患者应具有与低碳酸血症相关的许多主诉。最近的研究对低碳酸血症和主诉之间的密切关系提出了质疑。然而，后者可以维持和/或引发时，在没有低碳酸血症的情况下，其中第一次过度通气和低碳酸血症复发。因此，诊断的主要方法是检测导致低碳酸血症的（可能的）呼吸失调的体征。过度换气综合征的治疗方法有几个阶段和/或程度的干预：心理咨询，物理治疗和放松，最后是药物治疗。根据问题的严重程度，可以选择一种或多种治疗策略。
Hyperventilation is defined as breathing in excess of the metabolic needs of the body, eliminating more carbon dioxide than is produced, and, consequently, resulting in respiratory alkalosis and an elevated blood pH. The traditional definition of hyperventilation syndrome describes "a syndrome, characterized by a variety of somatic symptoms induced by physiologically inappropriate hyperventilation and usually reproduced by voluntary hyperventilation". The spectrum of symptoms ascribed to hyperventilation syndrome is extremely broad, aspecific and varying. They stem from virtually every tract, and can be caused by physiological mechanisms such as low Pa,CO2, or the increased sympathetic adrenergic tone. Psychological mechanisms also contribute to the symptomatology, or even generate some of the symptoms. Taking the traditional definition of hyperventilation syndrome as a starting point, there should be three elements to the diagnostic criterion: 1) the patient should hyperventilate and have low Pa,CO2, 2) somatic diseases causing hyperventilation should have been excluded, and 3) the patient should have a number of complaints which are, or have been, related to the hypocapnia. Recent studies have questioned the tight relationship between hypocapnia and complaints. However, the latter can be maintained and/or elicited when situations in the absence of hypocapnia in which the first hyperventilation and hypocapnia was present recur. Thus, the main approach to diagnosis is the detection of signs of (possible) dysregulation of breathing leading to hypocapnia. The therapeutic approach to hyperventilation syndrome has several stages and/or degrees of intervention: psychological counselling, physiotherapy and relaxation, and finally drug therapy. Depending on the severity of the problem, one or more therapeutic strategies can be chosen.