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目的 探讨慢性阻塞性肺病 (COPD)Ⅱ型呼吸衰竭患者及其子女的呼吸驱动反应性的变化 ,并对其遗传性进行初步探讨。方法 测定 6例COPDⅡ型呼吸衰竭患者及其 2 1名子女的口腔阻断压 (P0 .1) ,同时测定了P0 .1及分钟通气量 (VE)对低氧 (ΔP0 .1/ΔSaO2 和ΔVE/ΔSaO2 )和对高二氧化碳(ΔP0 .1/ΔPETCO2 和ΔVE/ΔPETCO2 )的反应性。结果 (1)COPDⅡ型呼吸衰竭患者的P0 .1显著高于其子女组和正常对照组 ,低氧呼吸中枢驱动反应性 (ΔP0 .1/ΔSaO2 )则显著低于子女组和正常对照组 (P <0 0 5 )。 (2 )受检患者的 10名子女低氧呼吸中枢驱动反应性低于正常对照组 ,而另 11名子女则正常 ,2组子女的性别分布均等。 (3)患者组高二氧化碳通气反应性 (ΔVE/ΔPETCO2 )显著低于正常对照组 ,子女ΔVE/ΔPETCO2 变异范围较大。结论 (1)低氧呼吸中枢驱动反应性降低可能是导致COPD患者发生二氧化碳潴留的原因。 (2 )低氧呼吸中枢驱动反应性降低可能受遗传因素的影响。
Objective To investigate the changes of respiratory responsiveness in patients with chronic obstructive pulmonary disease (COPD) type Ⅱ respiratory failure and their children, and to explore the genetic basis. Methods The oral occlusion pressure (P0.1) was measured in 6 patients with COPD type Ⅱ respiratory failure and their 21 children. The effects of P0.1 and minute ventilation (VE) on hypoxia (ΔP0.1 / ΔSaO2 and ΔVE / ΔSaO2) and reactivity to high carbon dioxide (ΔP0.1 / ΔPETCO2 and ΔVE / ΔPETCO2). Results (1) The P0.1 of COPD type Ⅱ patients with respiratory failure was significantly higher than that of their children and controls (P <0.01), and the reactive oxygen species (ΔP0.1 / ΔSaO2) was significantly lower than that of the children and the normal controls <0 0 5). (2) The responsiveness of hypoxia respiratory center of 10 children under test was lower than that of normal control group, while the other 11 children were normal, and the gender distribution of the two groups of children was equal. (3) The high CO2 reactivity (ΔVE / ΔPETCO2) was significantly lower in the patient group than in the normal control group, and the variation range of ΔVE / ΔPETCO2 in children was larger. Conclusions (1) The reduced hypoxic driving of central respiratory system may be responsible for the occurrence of carbon dioxide retention in COPD patients. (2) hypoxia respiratory center drive responsiveness may be affected by genetic factors.