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目的:在完成吸入室内空气状态下症状限制性最大极限心肺运动试验(CPET)和动脉血气指标动态变化规律的基础上,进一步探讨体液酸碱度和CO2含量对呼吸调控的影响。方法:选正常志愿者5名,给予5%Na HCO3(总量0.3 g/kg)分次口服,每5 min口服75 ml(3.75g)。总量服完1 h后,重复CPET。于静息、热身、运动及恢复期,连续测定肺通气指标及每分钟动脉取样的血气指标变化,并与本人在非碱化血液条件下对照数据进行配对t检验比较。结果:碱化血液之后,CPET期间随着运动功率逐步递增,气体交换和血气指标的反应模式与非碱化血液对照相似(P>0.05);即与静息状态比较,每分通气量、潮气量、呼吸频率、V4O2、V4CO2均呈现近于线性渐进性递增(P<0.05~0.001)。与碱化血液前吸入室内空气的对照比较:在碱化血液条件下,所有时间点血红蛋白浓度,PaCO2与p H均显著提高(P<0.05);除无氧阈Pa CO2减低外,只有热身状态呈增高态势,统计学有显著差异(P<0.05);而PaO2无差异(P>0.05),各状态均较对照状态减低,除恢复期外均有统计学差异(P<0.05)。与非碱化血液对照比较,除静息每分通气量低于对照(P<0.05)外,所有通气指标均无统计学差异(P>0.05)。结论:碱化血液条件下,尽管有更高的Ca CO2,Pa CO2和p Ha平均水平及更低的Hba和[H+]a平均水平,机体对CPET的呼吸反应模式基本相似。
OBJECTIVE: To further investigate the effects of body fluid pH and CO2 content on respiratory regulation on the basis of the dynamic changes of maximum limiting cardiopulmonary exercise test (CPET) and arterial blood gas index under inhalation of indoor air. Methods: Five normal volunteers were given orally with 5% Na HCO3 (0.3 g / kg) and 75 ml (3.75 g) orally every 5 minutes. After the total amount of 1h, repeated CPET. During rest, warm-up, exercise and convalescence, the indexes of pulmonary ventilation and arterial blood sampling per minute were continuously measured. The changes of blood gas index were compared with the control data of non-alkalized blood. Results: After basing on blood, the kinetic power gradually increased during CPET. The patterns of gas exchange and blood gas index were similar to those of non-alkalinized blood (P> 0.05); that is, compared with resting state, minute ventilation, Volume, respiratory rate, V4O2, V4CO2 showed nearly linear incremental (P <0.05 ~ 0.001). Compared with baseline inhalation of indoor air before alkalinization, hemoglobin concentration, PaCO2 and p H were all significantly increased (P <0.05) at all time points under basified blood conditions; only the warm-up state (P <0.05). There was no significant difference between PaO2 and PaO2 (P> 0.05). All the states were lower than the control group except the recovery period (P <0.05). Compared with non-alkalinized blood control, all ventilatory indexes showed no significant difference (P> 0.05), except the resting ventilator per minute was lower than the control (P <0.05). CONCLUSIONS: In basified blood conditions, the body’s respiratory response patterns to CPET are similar, despite higher mean levels of CaCO 2, PaCO 2 and p Ha and lower mean levels of Hba and [H +] a.