Andersen L H, Secher N J
Thorax. 1976 Dec;31(6):685-92. doi: 10.1136/thx.31.6.685.
Closing volume (single breath nitrogen test), regional ventilation and perfusion (using intravenous xenon-133), and total lung function (TLC, VC, and FEV) were measured before and after intramuscular administration of 250 mug 15-methyl prostaglandin F2alpha (15-me PGF2alpha) in 10 healthy women. The cardiac output was measured with the Minnesota impedance cardiograph model 304A and the transthoracic impedance was used as an expression of the thoracic fluid volume. The slope of the alveolar plateau on the closing volume tracing showed a 271% increase 20 minutes after the prostaglandin administration, at which time the closing volume per cent (CV%) had decreased (P less than 0-01) and the closing capacity (CC%) had increased (P less than 0-05). Vital capacity (VC) decreased (P less than 0-01), residual volume (RV) increased (P less than 0-01), and the total lung capacity (TLC) remained unchanged. The maximal decrease (9%) in FEV1 was seen after 20 minutes. All these measurements except the slope of the alveolar plateau returned to control levels after 60 minutes. The redistribution of regional ventilation was more pronounced than that of the regional pulmonary blood flow. No change was observed in cardiac output and transthoracic impedance. None of the patients experienced any dyspnoea. Our results are consistent with a more pronounced effect of prostaglandin F2alpha on the small airways (the alveolar plateau) than on the larger airways (FEV1). In cases where an increase in the slope of the alveolar plateau is observed, the closing volume per cent should not be used as a measurement of the lung disease. It is concluded that the single breath nitrogen test (N2 closing volume) is more sensitive than the conventional tests.
在10名健康女性肌肉注射250微克15 - 甲基前列腺素F2α(15 - me PGF2α)前后,测量了闭合气量(单次呼吸氮试验)、局部通气与灌注(使用静脉注射氙 - 133)以及肺总功能(肺总量、肺活量和第一秒用力呼气量)。使用明尼苏达阻抗心动图模型304A测量心输出量,并将经胸阻抗用作胸内液体量的指标。在注射前列腺素后20分钟,闭合气量描记图上的肺泡平台斜率增加了271%,此时闭合气量百分比(CV%)下降(P<0.01),闭合容量(CC%)增加(P<0.05)。肺活量(VC)下降(P<0.01),残气量(RV)增加(P<0.01),而肺总量(TLC)保持不变。20分钟后观察到第一秒用力呼气量(FEV1)最大下降了9%。除肺泡平台斜率外,所有这些测量值在60分钟后均恢复到对照水平。局部通气的重新分布比局部肺血流的重新分布更明显。心输出量和经胸阻抗未观察到变化。所有患者均未出现任何呼吸困难。我们的结果表明,前列腺素F2α对小气道(肺泡平台)的作用比对大气道(FEV1)的作用更明显。在观察到肺泡平台斜率增加的情况下,闭合气量百分比不应作为肺部疾病的测量指标。结论是,单次呼吸氮试验(氮闭合气量)比传统试验更敏感。