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首页> 外文期刊>American Journal of Physiology >Reduced baroreflex sensitivity and pulmonary dysfunction in alcoholic cirrhosis: Effect of hyperoxia
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Reduced baroreflex sensitivity and pulmonary dysfunction in alcoholic cirrhosis: Effect of hyperoxia

机译：酒精性肝硬化患者的压力反射敏感性降低和肺功能障碍：高氧的影响

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摘要

Patients with cirrhosis exhibit impaired regulation of the arterial blood pressure, reduced baroreflex sensitivity (BRS), and prolonged QT interval. In addition, a considerable number of patients have a pulmonary dysfunction with hypoxemia, impaired lung diffusing capacity (DLCO), and presence of hepatopulmonary syndrome (HPS). BRS is reduced at exposure to chronic hypoxia such as during sojourn in high altitudes. In this study, we assessed the relation of BRS to pulmonary dysfunction and cardiovascular characteristics and the effects of hyperoxia. Forty-three patients with cirrhosis and 12 healthy matched controls underwent hemodynamic and pulmonary investigations. BRS was assessed by cross-spectral analysis of variabilities between blood pressure and heart rate time series. A 100% oxygen test was performed with the assessment of arterial oxygen tensions (PaO 2) and alveolar-arterial oxygen gradient. Baseline BRS was significantly reduced in the cirrhotic patients compared with the controls (4.7 ± 0.8 vs. 10.3 ± 2.0 ms/mmHg; P 0.001). The frequency-corrected QT interval was significantly prolonged in the cirrhotic patients (P 0.05). There was no significant difference in BRS according to presence of HPS, PaO 2, DLCO, or Child-Turcotte score, but BRS correlated with metabolic and hemodynamic characteristics. After 100% oxygen inhalation, BRS and the QT interval remained unchanged in the cirrhotic patients. In conclusion, BRS is significantly reduced in patients with cirrhosis compared with controls, but it is unrelated to the degree of pulmonary dysfunction and portal hypertension. Acute hyperoxia does not significantly revert the low BRS or the prolonged QT interval in cirrhosis.
机译：肝硬化患者表现出动脉血压调节不良，压力反射敏感性（BRS）降低和QT间隔延长。另外，相当多的患者患有低氧血症，肺扩散能力受损（DLCO）和肝肺综合征（HPS）的肺功能不全。暴露于慢性低氧时（例如在高海拔地区逗留期间），BRS降低。在这项研究中，我们评估了BRS与肺功能障碍和心血管特征的关系以及高氧的影响。对43例肝硬化患者和12个健康匹配对照进行了血流动力学和肺部检查。通过对血压和心率时间序列之间的变异性进行互谱分析来评估BRS。进行100％氧气测试，评估动脉血氧张力（PaO 2）和肺泡-动脉血氧梯度。与对照组相比，肝硬化患者的基线BRS显着降低（4.7±0.8 vs. 10.3±2.0 ms / mmHg; P <0.001）。肝硬化患者经频率校正的QT间隔明显延长（P <0.05）。根据HPS，PaO 2，DLCO或Child-Turcotte评分的存在，BRS没有显着差异，但BRS与代谢和血液动力学特征相关。肝硬化患者吸入100％氧气后，BRS和QT间隔保持不变。总之，与对照组相比，肝硬化患者的BRS显着降低，但与肺功能障碍和门脉高压的程度无关。急性高氧不能显着恢复低BRS或延长肝硬化的QT间隔。

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