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不同大小气道对跨肺压的体内尺寸反应。

In vivo dimensional response of airways of different size to transpulmonary pressure.

作者信息

Tisi G M, Minh V D, Friedman P J

出版信息

J Appl Physiol. 1975 Jul;39(1):23-9. doi: 10.1152/jappl.1975.39.1.23.

DOI:10.1152/jappl.1975.39.1.23
PMID:1150587
Abstract

We studied four supine dogs that were anesthetized with pentobarbital, intubated, and ventilated with a piston pump. The dimensional response of central (CAW) (greater than 2 mm diam) and peripheral airways (PAW) (smaller than 2 mm diam) to changes in transpulmonary pressure (Ptp) was determined by progressive increments in tidal volume (VT). A specially designed electronics relay circuit permitted this relationship to be obtained for points of no flow during tidal volume breathing: i.e., preinspiration (FRC); end inspiration (FRC + VT). The airways were dusted with powdered tantalum. Six airway divisions were identified: four CAW: trachea, main stem, lobar, segmental; and two PAW: subsegmental, and lobular. AP and lateral roentgenograms were obtained by standard technics and primary magnification (mag factor 2). Airway diameters were plotted as a function of transpulmonary pressure between 3 and 26 cmH2O with the diameter at total lung capacity expressed as 100%. The data show that: 1) there is significant distensibility above 5 cmH2O for all airways from the trachea to the lobular airways; 2) that the pressure-diameter plot is a linear plot for each airway from 3 to 26 cmH2O with R values between 0.846 and 0.957; 3) the peripheral lobular airways are more distensible than the central airways (P smaller than 0.05). We attribute the difference in distensibility of the peripheral lobular airways to their lack of cartilaginous support, and their decreased muscular support when compared to the CAW.

摘要

我们研究了四只经戊巴比妥麻醉、插管并用活塞泵通气的仰卧位犬。通过逐步增加潮气量(VT)来确定中央气道(CAW,直径大于2mm)和外周气道(PAW,直径小于2mm)对跨肺压(Ptp)变化的尺寸反应。一个专门设计的电子继电器电路使得在潮气量呼吸期间无气流点(即吸气前(功能残气量);吸气末(功能残气量+潮气量))能够获得这种关系。气道用钽粉撒布。识别出六个气道分支:四个中央气道:气管、主支气管、叶支气管、段支气管;以及两个外周气道:亚段支气管和小叶支气管。通过标准技术和一次放大(放大倍数2)获得前后位和侧位X线片。将气道直径绘制为跨肺压在3至26cmH₂O之间的函数,总肺容量时的直径表示为100%。数据显示:1)从气管到小叶气道的所有气道在5cmH₂O以上具有显著的可扩张性;2)对于每个气道,压力-直径图在3至26cmH₂O之间是线性图,相关系数R值在0.846至0.957之间;3)外周小叶气道比中央气道更具可扩张性(P小于0.05)。我们将外周小叶气道可扩张性的差异归因于其缺乏软骨支撑以及与中央气道相比肌肉支撑减少。

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