高・低容量酸素吸引試験とくにその血行力学にたいする影響について
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概要
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The cardio-repiratory changes caused by the inhalation of the oxygen-nitrogen gas mixture ranging from 10 to 100 %, one after another were observed in six patients with arterial hypertension, two with pulmonary emphysema in due consideration of the chemoreceptoric nerve reflex. 1. There occurs markedly the immediate response at 3'〜5', and the delayed response at 7'〜10' from the beginning of the hypoxic inhalation test. While in the immediate response the extent of the respiratory changes is superior to that of the circulatory, in the delayed response the former is inferior to the latter. In the immediate response the role of the chemoreceptoric nerve reflex is more dominant than that of the respiratory center, whereas in the delayed response the former is less leading than the latter. 2. The reactivity of the chemoreceptors, especially of both carotid and aortic bodies during the inhalation of the gas mixture varies with the kinds of diseases, particularly the severity of the hypoxaemic state at the examination; in general the hypoxaemic reflex action of the chemoreceptors tends to be fairly augmented in the arterial hypertension. 3. Minute volume, total peripheral vascular resistance and volume elasticity module were estimated by Wezler's new method in course of time. As a rule there develops a tendency to increase in minute volume and decrease in both peripheral vascular resistance and volume elasticity module, yet these circulatory dynamical changes depend so variously upon the cardiac and peripheral vascular states of patients that the integrate conclusion can not necessarily be drawn. 4. In some cases the blood pressure is moderately elevated by the inhalation of high content of oxygen as Comroe has pointed out, this phenomenon may be due to the enhanced, tonicity of vasoconstrictors, taking the augmented total vascular resistance on such occasion into consideration. In connection with above mentioned observations, the following examination was performed. Instead of the muscular exercise test in H.C. Landen's "spirographisch-ergonometrische Untersuchungsmethode," the inhalation of the 12 % oxygen-nitrogen gas mixture was adopted; namely, 21 %, 12 %, 21 % and 80 % oxygen in due order was inhaled, in a short space of time, in nine cases of normal health, 16 of cardiac disorders and 14 of hyperthyroidism in which the oxygen consumption was determined respectively. 1. In cases of sound health by the hypoxic inhalation, the oxygen consumption is very slightly reduced, whereas by the inhalation of 80 % oxygn, the consumption recovers to the level before the initiation of the test. 2. In cardiac disorders by means of the hypoxic inha'a Lion, the oxygen consumption decreases in its amount markedly, but by the inhalation of 21 % O_2, the consumption increases passably and by the inhalation of 80 % O_2 it decreases somewhat or remains unchanged. These changes are found quite typical in all congestive heart failure and the cardiac recompensation turns the mode of the consumption to the normal pattern. 3. In hyperthyroidism by the hypoxic inhalation the oxygen consumption decreases in its amount as well as in cardiac disorders, but the thereafter consumption has a tendency to increase sustainingly by the inhalation of both 21 % and 80 % oxygen. 4. In hyperthyrotic heart disease the mode of the changes is quite as similar as in the cardiac diseases above mentioned.
- 千葉大学の論文