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目的:从整体整合生理学来看,气体弥散功能取决于呼吸系统和循环系统的功能正常,以及二者之间良好的匹配。但传统系统生理学把弥散功能单纯划归为肺功能指标来分析和解读。由于忽略了循环系统的作用,DLCO判读可能会产生误区。方法:依据新创立的整体整合生理学医学理论构架,以呼吸、循环和代谢等系统为核心,在神经体液的调控下,以呼吸和循环优化匹配为基础,进行对于弥散功能的解读探讨。特别是心衰状态对弥散功能的影响进行分析和探讨。结果:理论上弥散功能取决于呼吸和循环以及它们的正常匹配。对于心衰患者的病理生理改变的特点以及在心衰条件下可产生的心源性弥散功能障碍进行分析和推测。结论:弥散功能的正常取决于正常的呼吸和循环以及它们的良好匹配。在心衰患者中呼吸和循环匹配差,虽然左心泵血功能的受限,在一定程度上使得肺血容量增大,但是同时肺血流速度降低,肺弥散膜厚度增厚和弥散距离增加,推测得出结论——心衰患者气体弥散功能应该降低而非增高。
OBJECTIVES: From the perspective of overall integrated physiology, the gas dispersion function depends on the normal functioning of the respiratory and circulatory systems and a good match between the two. However, the traditional system of physiology, diffuse function simply classified as lung function indicators to analyze and interpret. Due to the neglect of the circulatory system, DLCO interpretation can create misunderstandings. Methods: Based on the newly integrated theory of integrated physiology and medical theory, taking respiratory, circulatory and metabolic systems as the core, the disintegration function was interpreted based on optimal matching of respiration and circulation under the control of neurohumoral fluid. In particular, the effect of heart failure status on diffuse function is analyzed and discussed. Results: The theoretical diffusivity depends on the breathing and circulation and their normal matching. The characteristics of pathophysiological changes in patients with heart failure and heart-derived diffuse dysfunction in heart failure conditions were analyzed and speculated. Conclusion: Normal diffusion function depends on normal breathing and circulation and their good match. Poor breathing and circulation in patients with heart failure, although limited left ventricular pump function, to a certain extent, increased pulmonary blood volume, but at the same time lower pulmonary blood flow velocity, thickening of the diffusion membrane thickness and diffusion distance increased , Speculated that the conclusion - gas dispersion in patients with heart failure should be reduced rather than increased.