山东大学医学院病理生理学教研室50

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1、hypoxia王婧婧山东大学医学院病理生理学教研室氧气的获得和利用:ventilationgasexchangeinternalrespirationexternalrespirationairalveoliAlveolarcapillaryGastransportTissuecellsConcept运送氧或利用氧发生障碍时，机体发生功能、代谢、形态结构改变的病理过程.Tissuecellscan’tobtainenoughoxygenorcan’tfullyutilizeoxygen→metabolic,functionalandstructuralchangesParameters

2、ofbloodgas1.PartialpressureofO2（PO2）2.O2capacity（CO2max）3.O2content（CO2）4.O2saturation（SO2）1.PartialpressureofO2（PO2）溶解在血液中的氧所产生的张力。ThepressureortensionproducedbyphysicallydissolvedO2intheblood.Normal:PaO2:100mmHg吸入气氧分压Influencedby:theoxygenpressureintheinhaliedairextra-respirationNormal:PvO2:40

3、mmHgInfluencedbyintra-respiration2.O2capacity（CO2max）100ml血液中的Hb被氧充分饱和时的最大携氧量MaximumamountofO2thatcanbecombinedchemicallywiththeHbin100mlblood.Normal:20ml/dl(15gHb/100mlblood)InfluencedbytheamountofqualityandquantityofHb100mlHb的实际携氧量TheconcentrationofO2inabloodsampleNormal:CaO2:19ml/dl,CvO2:14ml

4、/dl3.O2content（CO2）InfluencedbythePO2andCO2maxThedifferencebetweenCaO2andCvO2动静脉血氧差:动脉血氧含量-静脉血氧含量19ml/dl14ml/dl5ml/dlO2O2O2O2O2AVCaO2--CvO2Reflecttheoxygenconsumptionrateofthetissue.4.O2saturation（SO2）Normal：SaO295%SvO275%InfluencedbythePO2指Hb结合氧的百分数AmountofoxygenactuallycombinedwithHb,expressed

5、asapercentageofoxygencapacity.CO2–O2ofphysicalsolutionCO2max100%=2,3-DPG2,3-DPGP50HypoxiaIntroductionClassification,etiologyandpathogenesisFunctionalandmetabolicchangesFactorsinvolvedintolerancetohypoxiaOxygentreatmentandoxygentoxicityAirGastransport+HbcirculationTissuecellsExternalrespirationC

6、lassification血液性缺氧Hemichypoxia循环性缺氧Circulatoryhypoxia低张性缺氧Hypotonichypoxia组织性缺氧Histogenoushypoxia低张性缺氧Hypotonichypoxia血液性缺氧Hemichypoxia循环性缺氧Circulatoryhypoxia组织性缺氧Histogenoushypoxia1.Hypotonichypoxia—PaO2↓Causes:1)PiO2↓:highaltitude(3000~4000m)海拔高度大气压PiO2PAO2SO2(m)(mmHg)(mmHg)(mmHg)%海平面760159105

7、9510006801409094200060012570923000530110629050004058545753667440708000270563050氧分压与氧饱和度的关系——氧离曲线2040608010020406080100氧饱和度%氧分压(mmHg)pH↓2,3-DPG↑Temp↑NO↑3000m呼吸中枢抑制脊髓高位损伤脊髓前角细胞受损运动神经受损呼吸肌无力弹性阻力增加胸壁损伤气道狭窄或阻塞Hypoventilation2)Dys