过度换气综合症

过度换气综合症
类型	过度换气
分类和外部资源
医学专科	精神病学、神经学、胸腔医学
ICD-10	R06.4 or F45.33
ICD-9-CM	306.1
DiseasesDB	31118
eMedicine	emerg/270
	[编辑此条目的维基数据]

过度换气综合症（英语：Hyperventilation syndrome、缩写：HVS），或称慢性过度换气综合症（Chronic hyperventilation syndrome、CHVS）、失能性过度换气综合症（Dysfunctional breathing hyperventilation syndrome），是由过快或过深的呼吸所造成，导致身体排出过多的二氧化碳，引发呼吸性碱中毒，亦即血液pH值过高，影响了神经系统的正常放电生理过程，部分患者会感到在手、足、唇等部位感到麻痹或微微叮咬感、口齿不清、晕眩、胸痛、心跳加速。患者越紧张，呼吸越快，令症状出现恶性循环，严重者更会昏厥。

该症状可由生理或心理造成，患者误以为自己缺氧，加快呼吸，但其动脉血中的氧化量仍然正常，只是二氧化碳含量过低，引致血管收缩，同时因为玻尔效应的影响，让人体对重要器官的输氧量减少。

诊断

过度换气综合症是晕眩症十分常见的诱因。 25%的晕眩症患者被诊断患有HVS。最佳诊断方法是让患者快速呼吸两分钟。这样会诱发症状，以确定患者的症状是由于呼吸过度导致的。这项检查只能在患者没有症状的时候进行。

流行慢性病

每分钟呼吸量是每分钟由一个人的肺一分钟吸入或呼出的空气量。呼吸医学资料（见下表）显示病人的呼吸的空气量是未患病人士的2-3倍。^{[来源请求]}

情况	每分钟呼吸量（±标准差）	病人数量	参考文献
呼吸正常	6 l/分钟	无	医学教科书: ^[1] ^[2] ^[3] ^[4]
哮喘	12 l/分钟	101	^[5]
哮喘	15 l/分钟	8	^[6]
哮喘	14.1 (±5.7) l/分钟	39	^[7]
心脏病	14 (±4) l/分钟	88	^[8]
心脏病	12.2 (±3.3) l/分钟	132	^[9]
心脏病	16 (±2) l/分钟	11	^[10]
心脏病	15 (±4) l/分钟	22	^[11]
糖尿病	10-20 l/分钟	28	^[12]
糖尿病	12-17 l/分钟	26	^[13]
囊肿性纤维化	11-14 l/分钟	6	^[14]
囊肿性纤维化	13 (±1.8) l/分钟	10	^[15]
慢性阻塞性肺病(COPD)	12.2 (±1.9) l/分钟	10	^[16]
肝硬化	11-18 l/分钟	24	^[17]
过度换气	14.9 (±0.6) l/分钟	42	^[18]
癫痫	12.8 l/分钟	12	^[19]

参考文献

^ Ganong WF, Review of medical physiology, 15-th ed., 1995, Prentice Hall Int., London.
^ Guyton AC, Physiology of the human body, 6-th ed., 1984, Suanders College Publ., Philadelphia.
^ McArdle W.D., Katch F.I., Katch V.L., Essentials of exercise physiology (2-nd edition); Lippincott, Williams and Wilkins, London 2000.
^ Straub NC, Section V, The Respiratory System, in Physiology, eds. RM Berne & MN Levy, 4-th edition, Mosby, St. Louis, 1998.
^ McFadden ER & Lyons HA, Arterial-blood gases in asthma, The New Engl J of Med 1968 May 9, 278 (19): 1027-1032.
^ Johnson BD, Scanlon PD, Beck KC, Regulation of ventilatory capacity during exercise in asthmatics, J Appl Physiol. 1995 Sep; 79(3): 892-901.
^ Bowler SD, Green A, Mitchell CA, Buteyko breathing techniques in asthma: a blinded randomised controlled trial, Med J of Australia 1998; 169: 575-578.
^ 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.
^ 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.
^ 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.
^ 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.
^ 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.
^ 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.
^ Tepper RS, Skatrud B, Dempsey JA, Ventilation and oxygenation changes during sleep in cystic fibrosis, Chest 1983; 84; p. 388-393.
^ 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.
^ 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.
^ 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.
^ 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.
^ 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.

外部链接

[Ganong-1] Ganong WF, Review of medical physiology, 15-th ed., 1995, Prentice Hall Int., London.

[Guyton-2] Guyton AC, Physiology of the human body, 6-th ed., 1984, Suanders College Publ., Philadelphia.

[McArdle-3] McArdle W.D., Katch F.I., Katch V.L., Essentials of exercise physiology (2-nd edition); Lippincott, Williams and Wilkins, London 2000.

[Straub-4] Straub NC, Section V, The Respiratory System, in Physiology, eds. RM Berne & MN Levy, 4-th edition, Mosby, St. Louis, 1998.

[McFadden-5] McFadden ER & Lyons HA, Arterial-blood gases in asthma, The New Engl J of Med 1968 May 9, 278 (19): 1027-1032.

[JohnsonBD1-6] Johnson BD, Scanlon PD, Beck KC, Regulation of ventilatory capacity during exercise in asthmatics, J Appl Physiol. 1995 Sep; 79(3): 892-901.

[Bowler-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.

[Clark-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.

[Fanfulla-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.

[JohnsonBD2-10] 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.

[Dimopoulou-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.

[Tantucci-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.

[Bottini-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.

[Tepper-14] Tepper RS, Skatrud B, Dempsey JA, Ventilation and oxygenation changes during sleep in cystic fibrosis, Chest 1983; 84; p. 388-393.

[Bell-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.

[Sinderby-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.

[Epstein-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.

[Kahaly-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.

[Esquivel-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.

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