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過度換氣症候群

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過度換氣症候群
分類系統及外部資源
ICD-10 R06.4 or F45.33
ICD-9 306.1
DiseasesDB 31118
eMedicine emerg/270

过度换气综合症英语Hyperventilation syndrome,簡稱:HVS,是由過快或過深的呼吸所造成,導致身體排出過多的二氧化碳,引發呼吸性碱中毒,亦即血液pH值過高,影響了神经系统的正常放电生理过程,部分患者會感到在等部位感到麻痺或微微叮咬感、口齒不清、暈眩胸痛心跳加速、手腳冰冷、緊張地笑。患者越緊張,呼吸越快,令症狀出現惡性循環,嚴重者更會昏厥

該症狀可由生理心理造成,患者誤以為自己缺氧,加快呼吸,但其動脈血中的氧化量仍然正常,只是二氧化碳含量過低,引致血管收縮,同时因為玻尔效应的影響,讓人體對重要器官的輸氧量減少。

危險因素[编辑]

很多患有恐懼症以及陌生環境恐懼症的患者可能會出現過度換氣綜合症。然而,大多數患有过度换气综合症的患者沒有這些疾病。

診斷[编辑]

过度换气综合症是暈眩症十分常見的誘因。 25%的暈眩症患者被診斷患有HVS。最佳診斷方法是讓患者快速呼吸兩分鐘。這樣會誘發症狀,以確定患者的症狀是由於呼吸過度導致的。這項檢查只能在患者沒有症狀的時候進行。

流行慢性病[编辑]

每分鐘呼吸量是每分鐘由一個人的肺一分鐘吸入或呼出的空氣量。呼吸醫學資料(見下表)顯示病人的呼吸的空氣量是未患病人士的2-3倍。[來源請求]

情况 每分鐘呼吸量(±標準差) 病人數量 參考文獻
呼吸正常 6 l/分鐘 醫學教科書: [1] [2] [3] [4]
哮喘 12 l/分鐘 101 [5]
哮喘 15 l/分鐘 8 [6]
哮喘 14.1 (±5.7) l/分鐘 39 [7]
心臟病 14 (±4) l/分鐘 88 [8]
心臟病 12.2 (±3.3) l/分鐘 132 [9]
心臟病 16 (±2) l/分鐘 11 [10]
心臟病 15 (±4) l/分鐘 22 [11]
糖尿病 10-20 l/分鐘 28 [12]
糖尿病 12-17 l/分鐘 26 [13]
囊腫性纖維化 11-14 l/分鐘 6 [14]
囊腫性纖維化 13 (±1.8) l/分鐘 10 [15]
慢性阻塞性肺病(COPD) 12.2 (±1.9) l/分鐘 10 [16]
肝硬化 11-18 l/分鐘 24 [17]
過度換氣 14.9 (±0.6) l/分鐘 42 [18]
癲癇 12.8 l/分鐘 12 [19]

参考文献[编辑]

  1. ^ Ganong WF, Review of medical physiology, 15-th ed., 1995, Prentice Hall Int., London.
  2. ^ Guyton AC, Physiology of the human body, 6-th ed., 1984, Suanders College Publ., Philadelphia.
  3. ^ McArdle W.D., Katch F.I., Katch V.L., Essentials of exercise physiology (2-nd edition); Lippincott, Williams and Wilkins, London 2000.
  4. ^ Straub NC, Section V, The Respiratory System, in Physiology, eds. RM Berne & MN Levy, 4-th edition, Mosby, St. Louis, 1998.
  5. ^ McFadden ER & Lyons HA, Arterial-blood gases in asthma, The New Engl J of Med 1968 May 9, 278 (19): 1027-1032.
  6. ^ Johnson BD, Scanlon PD, Beck KC, Regulation of ventilatory capacity during exercise in asthmatics, J Appl Physiol. 1995 Sep; 79(3): 892-901.
  7. ^ Bowler SD, Green A, Mitchell CA, Buteyko breathing techniques in asthma: a blinded randomised controlled trial, Med J of Australia 1998; 169: 575-578.
  8. ^ Clark AL, Chua TP, Coats AJ, Anatomical dead space, ventilatory pattern, and exercise capacity in chronic heart failure, Br Heart J 1995 Oct; 74(4): 377-380.
  9. ^ Fanfulla F, Mortara , Maestri R, Pinna GD, Bruschi C, Cobelli F, Rampulla C, The development of hyperventilation in patients with chronic heart failure and Cheyne-Stokes respiration, Chest 1998; 114; p. 1083-1090.
  10. ^ Johnson BD, Beck KC, Olson LJ, O'Malley KA, Allison TG, Squires RW, Gau GT, Ventilatory constraints during exercise in patients with chronic heart failure, Chest 2000 Feb; 117(2): 321-332.
  11. ^ Dimopoulou I, Tsintzas OK, Alivizatos PA, Tzelepis GE, Pattern of breathing during progressive exercise in chronic heart failure, Int J Cardiol. 2001 Dec; 81(2-3): 117-121.
  12. ^ Tantucci C, Scionti L, Bottini P, Dottorini ML, Puxeddu E, Casucci G, Sorbini CA, Influence of autonomic neuropathy of different severities on the hypercapnic drive to breathing in diabetic patients, Chest. 1997 Jul; 112(1): 145-153.
  13. ^ Bottini P, Dottorini ML, M. Cordoni MC, Casucci G, Tantucci C, Sleep-disordered breathing in nonobese diabetic subjects with autonomic neuropathy, Eur Respir J 2003; 22: p. 654–660.
  14. ^ Tepper RS, Skatrud B, Dempsey JA, Ventilation and oxygenation changes during sleep in cystic fibrosis, Chest 1983; 84; p. 388-393.
  15. ^ Bell SC, Saunders MJ, Elborn JS, Shale DJ, Resting energy expenditure and oxygen cost of breathing in patients with cystic fibrosis, Thorax 1996 Feb; 51(2): 126-131.
  16. ^ Sinderby C, Spahija J, Beck J, Kaminski D, Yan S, Comtois N, Sliwinski P, Diaphragm activation during exercise in chronic obstructive pulmonary disease, Am J Respir Crit Care Med 2001 Jun; 163(7): 1637-1641.
  17. ^ Epstein SK, Zilberberg MD; Facoby C, Ciubotaru RL, Kaplan LM, Response to symptom-limited exercise in patients with the hepatopulmonary syndrome, Chest 1998; 114; p. 736-741.
  18. ^ Kahaly GJ, Nieswandt J, Wagner S, Schlegel J, Mohr-Kahaly S, Hommel G, Ineffective cardiorespiratory function in hyperthyroidism, J Clin Endocrinol Metab 1998 Nov; 83(11): 4075-4078.
  19. ^ Esquivel E, Chaussain M, Plouin P, Ponsot G, Arthuis M, Physical exercise and voluntary hyperventilation in childhood absence epilepsy, Electroencephalogr Clin Neurophysiol 1991 Aug; 79(2): 127-132.

外部連結[编辑]