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姿势对机械通气期间腹肌活动时间的影响。

Posture effects on timing of abdominal muscle activity during stimulated ventilation.

作者信息

Abe T, Yamada T, Tomita T, Easton P A

机构信息

Department of Medicine, School of Medicine, Kitasato University, Kanagawa 228, Japan.

出版信息

J Appl Physiol (1985). 1999 Jun;86(6):1994-2000. doi: 10.1152/jappl.1999.86.6.1994.

Abstract

In humans during stimulated ventilation, substantial abdominal muscle activity extends into the following inspiration as postexpiratory expiratory activity (PEEA) and commences again during late inspiration as preexpiratory expiratory activity (PREA). We hypothesized that the timing of PEEA and PREA would be changed systematically by posture. Fine-wire electrodes were inserted into the rectus abdominis, external oblique, internal oblique, and transversus abdominis in nine awake subjects. Airflow, end-tidal CO2, and moving average electromyogram (EMG) signals were recorded during resting and CO2-stimulated ventilation in both supine and standing postures. Phasic expiratory EMG activity (tidal EMG) of the four abdominal muscles at any level of CO2 stimulation was greater while standing. Abdominal muscle activities during inspiration, PEEA, and PREA, were observed with CO2 stimulation, both supine and standing. Change in posture had a significant effect on intrabreath timing of expiratory muscle activation at any level of CO2 stimulation. The transversus abdominis showed a significant increase in PEEA and a significant decrease in PREA while subjects were standing; similar changes were seen in the internal oblique. We conclude that changes in posture are associated with significant changes in phasic expiratory activity of the four abdominal muscles, with systematic changes in the timing of abdominal muscle activity during early and late inspiration.

摘要

在人类进行刺激性通气时,大量的腹部肌肉活动会持续到接下来的吸气阶段,表现为呼气后呼气活动(PEEA),并在吸气后期再次开始,表现为呼气前呼气活动(PREA)。我们假设PEEA和PREA的时间会因姿势而发生系统性变化。将细线电极插入9名清醒受试者的腹直肌、腹外斜肌、腹内斜肌和腹横肌中。在仰卧位和站立位的静息和二氧化碳刺激通气期间,记录气流、呼气末二氧化碳和移动平均肌电图(EMG)信号。在任何二氧化碳刺激水平下,站立时四块腹部肌肉的阶段性呼气肌电活动(潮气量肌电)都更大。在仰卧位和站立位的二氧化碳刺激下,均观察到吸气、PEEA和PREA期间的腹部肌肉活动。在任何二氧化碳刺激水平下,姿势变化对呼气肌激活的呼吸内时间有显著影响。受试者站立时,腹横肌的PEEA显著增加,PREA显著减少;腹内斜肌也有类似变化。我们得出结论,姿势变化与四块腹部肌肉的阶段性呼气活动的显著变化相关,在吸气早期和后期腹部肌肉活动的时间有系统性变化。

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