脑梗死患者呼吸中枢驱动和呼吸功能的变化

Study on respiratory drive and respiratory function of patients with cerebral infarction

目的探讨脑梗死患者呼吸功能指标及呼吸中枢驱动力的变化，了解脑梗死对患者呼吸中枢及呼吸功能的影响。方法对35例脑梗死患者和15名健康对照分别进行血气分析、呼吸中枢驱动（P0.1）和肺功能测定，使用SPSS 10．0for Windows加以分析处理，两组之间各指标比较采用t检验。两因素之间的相关性分析采用直线相关分析。结果脑梗死患者血氧分压（mmHg，75．80±4．12，1mmHg=0．133kPa）、血氧饱和度（％，94．97±0．78）和最大口腔吸气压（PImax，kPa，4．076±2．443）明显低于健康对照组（分别为88．68±3．77，96．40±0．48和7．747±0．599，t值分别为-8．310、-5．731、-5．439，均P=0．000）。P0.1max和P0.1／每分钟通气量比健康对照组低，差异有统计学意义。P0.1／P0.1max、P0.1／PImax较健康对照组高，且差异有统计学意义。用力肺活量（FVC）、一秒用力呼气容积（FEV1.0）、呼气流速峰值（PEF）亦明显低于健康对照组。经相关分析，最大口腔吸气压与血氧分压、血氧饱和度、肺泡动脉氧压差、P0.1max、P0.1、P0.1／PImax、P0.1／P0.1max、FVC、FEV1.0、PEF密切相关；最大口腔呼气压与P0.1／PImax、FVC、FEV1.0、PEF密切相关。结论脑梗死患者呼吸功能受损，氧合指标降低、吸气及呼气功能均受累、中枢呼吸驱动力降低且中枢呼吸驱动储备下降。

Objective To detect Po. 1 and respiratory function of patients with cerebral infarction （CI） and analyze the effect of cerebral infarction on respiratory function. Methods Arterial blood gases, respiratory drive and lung function were measured in 35 cases with CI and 15 healthy controls. The figures were analyzed by SPSS 10. 0. Results The PaO2 （mm Hg, 75.80 ± 4. 12, 1 mm Hg = 0. 133 kPa）, SaO2 （%, 94.97 ± 0. 78） and Plmax （kPa, 4. 076 ± 2. 443 ） were lower than those in the healthy control group （88.68 ±3.77, 96.40 ± 0. 48 and 7. 747 ± 0. 599, t = - 8. 310, - 5. 731, - 5.439, all P = 0.000） o P0. 1 max and Po. 1/MV in the CI group were lower than those in the healthy control group; the P0. 1 did not have significant difference in these two group ; the P00. 1/P0. 1 max and P0. 1/PImax in the CI group were significantly higher than those in the healthy control group; the PImax was correlated with PO2,O2sat, P（A-a） O2, P0.1max, P0. 1, P0. 1/PImax, P0.1/Po.l max, FVC,FEV1.o and PEF; the PEmax was correlated with P0. 1/ PImax, FVC, FEV1.0 and PEF. Conclusion The respiratory function of patients with CI has been impaired, the oxygenated index is cut down and the respiratory drive and respiratory drive store are decreased.