EXCESSIVE POLYCYTHEMIA OF HIGH-ALTITUDE - ROLE OF VENTILATORY DRIVE AND LUNG-DISEASE
EXCESSIVE POLYCYTHEMIA OF HIGH-ALTITUDE - ROLE OF VENTILATORY DRIVE AND LUNG-DISEASE
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DOI：
10.1164/arrd.1978.118.4.659
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发表时间：
1978-01-01
期刊：
影响因子：
--
通讯作者：
GROVER, RF
中科院分区：
文献类型：
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作者：
KRYGER, M;MCCULLOUGH, R;GROVER, RF
高海拔地区红细胞增多症患者比正常的高海拔地区居民更容易出现低氧血症。本文对20例居住在海拔3100米地区的红细胞增多症患者进行了低氧血症的病因分析。20例患者中有10例患者存在肺功能异常和呼吸问卷结果显示的肺部疾病证据，并导致肺泡-动脉PO 2 [O2分压] [（A-a）PO 2]差异增加。肺功能正常者的过度低氧血症不是由于（A-a）PO 2升高所致。测量对低氧和高碳酸血症的通气反应，以确定这些反应的钝化是否是过度低氧血症的原因。红细胞增多症患者的呼吸化学驱动力虽然减弱，但与高海拔对照组相同。观察到异常的呼吸模式;红细胞增多症患者的潮气量较小，死腔与潮气量的比率大于正常受试者。此外，红细胞增多症患者呼吸100%O2时的每分钟通气量增加，而正常人则没有。可能存在低通气抑制。钝性化学驱力不是这种疾病的病因，必须存在其他一些导致低氧血症的原因。
Persons residing at high altitude who develop excessive polycythemia are more hypoxemic than normal high-altitude residents. The causes of hypoxemia in 20 patients with excessive polycythemia residing at an altitude of 3100 m were investigated. Lung disease evidencee by abnormal spirometric features and results of a respiratory questionnaire was present in 10 of 20 patients and resulted in increased alveolar-arterial difference for PO2 [O2 partial pressure] [(A-a)PO2]. The excessive hypoxemia in the patients with normal lungs was not due to increased (A-a)PO2. Ventilatory responses to hypoxia and to hypercapnia were measured to determine whether blunting of these responses was a cause of this excessive hypoxemia. Chemical drives to breathe, although blunted, were the same in patients with polycythemia as in high-altitude control subjects. An abnormal breathing pattern was observed; the polycythemic patients had a smaller tidal volume and a greater ratio of dead space to tidal volume than did the normal subjects. In addition, the polycythemic patients had increased minute ventilation on breathing 100% O2, whereas the normal subjects did not. Hypoxic depression of ventilation may have been present. Blunted chemical drives were not causative in this disease and some other cause of hypoxemia must be present.