抄録
The effects of hyperoxygenation on carbohydrate metabolism were examined in 30 patients with chronic respiratory failure based on chronic obstructive pulmonary disease. Glycolytic metabolites and related substances were analyzed before and after 1 hour of pure oxygen inhalation. Decrease in blood glucose (4.2%) and lactate (27.2%) and increase in 2, 3-diphosphoglycerate (DPG, 5.0%) and lactic dehydrogenase (LDH)-3 (17.3%) were seen after oxygen inhalation in patients with moderate hypoxemia (n=14, mean PaO2=51mmHg). These metabolites except for 2, 3-DPG did not change in patients with slight hypoxemia (n=16, mean PaO2=67.4mmHg). Pyruvate, free fatty acid, LDH activity, LDH-1, 2, 4, and 5, and immunoreactive insulin did not change during hyperoxygenation. These results suggest that metabolic alteration due to hyperoxygenation is extremely rapid in patients with deteriorated lung function. Combined effects of tissue hyperoxygenation and concurrent respiratory acidosis are mechanisms probably involved. Increase in LDH-3 is especially noted perhaps because it may leak from lung tissue injured by oxygen.
