Altered respiratory physiology in obesity.
Altered respiratory physiology in obesity.
复制标题
改变肥胖的呼吸生理机能。
作者：
K. Parameswaran;David C. Todd;M. Soth
肥胖的主要呼吸并发症包括对通气的需求增加、呼吸功增加、呼吸肌效率低下和呼吸顺应性降低。功能性残气量和呼气储备量减少，关闭容积与功能性残气量比值高，与周围肺单位关闭、通气灌注比异常和低氧血症有关，尤其是在仰卧位。除了极端情况外，传统的呼吸功能测试仅受到肥胖的轻度影响。主要的循环系统并发症是总血容量和肺血容量增加、高心输出量和左心室舒张末期压升高。肥胖患者通常会出现通气不足和睡眠呼吸暂停综合征，伴有低氧和高碳酸血症的缓解反应减弱。最终的结果是低氧血症、肺动脉高压和逐渐恶化的残疾。肥胖患者呼吸困难增加，运动能力下降，这对生活质量至关重要。除了肥胖对心肺功能的影响外，肌肉减少、关节疼痛和皮肤摩擦增加也是运动能力下降的重要决定因素。肥胖对心力衰竭和慢性阻塞性肺疾病死亡率的影响尚未得到明确解决。肥胖是否会导致哮喘和气道高反应性尚不确定。减轻体重和体力活动是扭转肥胖呼吸系统并发症的有效手段。
The major respiratory complications of obesity include a heightened demand for ventilation, elevated work of breathing, respiratory muscle inefficiency and diminished respiratory compliance. The decreased functional residual capacity and expiratory reserve volume, with a high closing volume to functional residual capacity ratio of obesity, are associated with the closure of peripheral lung units, ventilation to perfusion ratio abnormalities and hypoxemia, especially in the supine position. Conventional respiratory function tests are only mildly affected by obesity except in extreme cases. The major circulatory complications are increased total and pulmonary blood volume, high cardiac output and elevated left ventricular end-diastolic pressure. Patients with obesity commonly develop hypoventilation and sleep apnea syndromes with attenuated hypoxic and hypercapnic ventilatory responsiveness. The final result is hypoxemia, pulmonary hypertension and progressively worsening disability. Obese patients have increased dyspnea and decreased exercise capacity, which are vital to quality of life. Decreased muscle, increased joint pain and skin friction are important determinants of decreased exercise capacity, in addition to the cardiopulmonary effects of obesity. The effects of obesity on mortality in heart failure and chronic obstructive pulmonary disease have not been definitively resolved. Whether obesity contributes to asthma and airway hyper-responsiveness is uncertain. Weight reduction and physical activity are effective means of reversing the respiratory complications of obesity.
胸部受限的正常坐位男性的肺力学和气体交换。
DOI：
10.1152/jappl.1981.51.1.26
发表时间：
1981
期刊：
Journal of applied physiology: respiratory, environmental and exercise physiology
影响因子：
--
作者：
Klineberg,PL;Rehder,K;Hyatt,RE
通讯作者：
Hyatt,RE
影响因子：
158.5
作者：
Kenchaiah, S;Evans, JC;Vasan, RS
通讯作者：
Vasan, RS