Effects of changes in level and pattern of breathing on the sensation of dyspnea.
Effects of changes in level and pattern of breathing on the sensation of dyspnea.
复制标题
呼吸水平和模式变化对呼吸困难感觉的影响。
DOI：
10.1152/jappl.1990.69.4.1290
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Cherniack,NS
中科院分区：
文献类型：
--
作者：
Chonan,T;Mulholland,MB;Altose,MD;Cherniack,NS
高碳酸血症期间的呼吸由反射机制决定，但也可能受到呼吸感觉的影响。本研究探讨了在恒定水平的化学驱动下，呼吸水平和呼吸模式的自主变化对呼吸困难感觉的影响。在15名正常男性受试者中进行了研究，在稳态高碳酸血症在潮气末PCO 2为50托。采用博格分类量表评定呼吸困难的严重程度。在一项实验中（n = 8），通气水平从自发采用的水平（Vspont）增加或降低。在另一个实验（n = 9）中，每分钟通气量保持在50 Torr的PCO 2下自发采用的水平，呼吸频率从自发采用的水平（fspont）增加或减少，潮气量发生相互变化。呼吸困难的强度（表示为自主呼吸水平的百分比）与通气量（% Vspont）在低于Vspont时呈负相关（r =-0.70，P <0.001），在高于Vspont时呈正相关（r = 0.80，P <0.001）。在恒定通气水平下，呼吸困难强度与呼吸频率（% fspont）在低于fspont的水平呈负相关（r =-0.69，P <0.001），在高于fspont的水平呈正相关（r = 0.75，P <0.001）。这些结果表明，当呼吸水平或模式从自发水平自愿改变时，呼吸困难加剧。这与以下可能性相一致：对化学驱力变化的解释性反应可能部分受到调节，以尽量减少呼吸努力和不适的感觉。
Breathing during hypercapnia is determined by reflex mechanisms but may also be influenced by respiratory sensations. The present study examined the effects of voluntary changes in level and pattern of breathing on the sensation of dyspnea at a constant level of chemical drive. Studies were carried out in 15 normal male subjects during steady-state hypercapnia at an end-tidal PCO2 of 50 Torr. The intensity of dyspnea was rated on a Borg category scale. In one experiment (n = 8), the level of ventilation was increased or decreased from the spontaneously adopted level (Vspont). In another experiment (n = 9), the minute ventilation was maintained at the level spontaneously adopted at PCO2 of 50 Torr and breathing frequency was increased or decreased from the spontaneously adopted level (fspont) with reciprocal changes in tidal volume. The intensity of dyspnea (expressed as percentage of the spontaneous breathing level) correlated with ventilation (% Vspont) negatively at levels below Vspont (r = -0.70, P less than 0.001) and positively above Vspont (r = 0.80, P less than 0.001). At a constant level of ventilation, the intensity of dyspnea correlated with breathing frequency (% fspont) negatively at levels below fspont (r = -0.69, P less than 0.001) and positively at levels above fspont (r = 0.75, P less than 0.001). These results indicate that dyspnea intensifies when the level or pattern of breathing is voluntarily changed from the spontaneously adopted level. This is consistent with the possibility that ventilatory responses to changes in chemical drive may be regulated in part to minimize the sensations of respiratory effort and discomfort.