Chronic mountain sickness: Recent studies of the relationship between hemoglobin concentration and oxygen transport
Chronic mountain sickness: Recent studies of the relationship between hemoglobin concentration and oxygen transport
复制标题
DOI：
10.1089/1527029041352090
复制
发表时间：
2004-06-01
影响因子：
2.1
通讯作者：
Leon-Velarde, F
中科院分区：
文献类型：
--
作者：
Reeves, JT;Leon-Velarde, F
虽然高原居民血红蛋白浓度[Hb]的增加有助于氧气运输，但过多的红细胞增多症（[Hb]大于或等于21 g/100 mL）可能会导致慢性高山病（CMS）综合征。最近的一项理论分析表明，将 [Hb] 增加到 18 g/100 mL 以上不会对静息时的氧输送带来任何进一步的好处。为了检验这一假设，我们根据 206 名不同海拔地区居民的报告，检查了给定动脉氧饱和度（Sa(O2)，以 5% 为间隔的班级）静息时的氧输送。对于 97% 与 87% 的 Sa(O2)，[Hb] 和 a-v 氧含量差异增加（分别为 14.5 至 17.5 g/100 mL 和 4.11 至 5.03 体积%）。随着 Sa(O2) 进一步下降至 66%，尽管 [Hb] 增加至 24.2 g/100 mL，但 a-v 逐渐下降至 3.77 体积%。在 Sa(O2) 范围为 97% 至 66% 时，Sa(O2) 变化范围为 97% 至 75%，与其他严重缺氧的受试者 (-33%) 相比，a-v 差异几乎没有变化 (-8%)。结果表明，增加 [Hb] 可以提高吸氧量（心输出量节约效应），在 Sa(O2) 为 87% 且 [Hb] 为 17.5 g/100 mL 时达到最大。对于更严重的低氧血症，甚至 Sa(O2) 为 66%，增加的 [Hb] 和增加的输出都用于氧运输。
Although an increase in hemoglobin concentration [Hb] in high altitude residents assists oxygen transport, excessive polycythemia ([Hb] greater than or equal to 21 g/100 mL) may cause the syndrome of chronic mountain sickness (CMS). A recent theoretical analysis has suggested that increasing [Hb] above 18 g/100 mL provides no further benefit in oxygen transport at rest. To test this hypothesis, we examined oxygen transport at rest for given arterial oxygen saturations (Sa(O2), in classes at intervals of 5%) as reported in 206 residents of various altitudes. For Sa(O2) of 97% Versus 87%, [Hb] and a-v oxygen content difference increased (respectively, 14.5 to 17.5 g/100 mL and 4.11 to 5.03 volume %). As Sa(O2) fell further to 66%, a-v progressively decreased to 3.77 volume %, despite an increase in [Hb] to 24.2 g/100 mL. Over the Sa(O2) range of 97% to 66%, the a-v difference changed little (-8%) compared to other subjects made acutely hypoxic (-33%), for Sa(O2) change from 97% to 75%. The results suggest that increasing [Hb] allows greater oxygen extraction (a cardiac output sparing effect), which is maximal at Sa(O2) of 87% and a [Hb] of 17.5 g/100 mL. For more severe hypoxemia, even to Sa(O2) of 66%, both increasing [Hb] and increasing output are utilized for oxygen transport.