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肺血管压力和血流对离体大鼠肺气道及实质力学的影响。

Effects of pulmonary vascular pressures and flow on airway and parenchymal mechanics in isolated rat lungs.

作者信息

Peták Ferenc, Habre Walid, Hantos Zoltán, Sly Peter D, Morel Denis R

机构信息

Division of Anesthesiologic Investigations, University of Geneva, 1211 Geneva, Switzerland.

出版信息

J Appl Physiol (1985). 2002 Jan;92(1):169-78. doi: 10.1152/jappl.2002.92.1.169.

Abstract

Changes in pulmonary hemodynamics have been shown to alter the mechanical properties of the lungs, but the exact mechanisms are not clear. We therefore investigated the effects of alterations in pulmonary vascular pressure and flow (Q(p)) on the mechanical properties of the airways and the parenchyma by varying these parameters independently in three groups of isolated perfused normal rat lungs. The pulmonary capillary pressure (Pc(est)), estimated from the pulmonary arterial (Ppa) and left atrial pressure (Pla), was increased at constant Q(p) (n = 7), or Q(p) was changed at Pc(est) = 10 mmHg (n = 7) and at Pc(est) = 20 mmHg (n = 6). In each condition, the airway resistance (Raw) and parenchymal damping (G) and elastance (H) were identified from the low-frequency pulmonary input impedance spectra. The results of measurements made under isogravimetric conditions were analyzed. The changes observed in the mechanical parameters were consistent with an altered Pla: monotonous increases in Raw were observed with increasing Pla, whereas G and H were minimal at Pla of approximately 7-10 mmHg and increased at lower and higher Pla. The results indicate that Pla, and not Ppa or Q(p), is the primary determinant of the mechanical condition of the lungs after acute changes in pulmonary hemodynamics: the parenchymal mechanics are impaired if Pla is lower or higher than physiological, whereas airway narrowing occurs at high Pla.

摘要

肺血流动力学的改变已被证明会改变肺的力学特性,但其确切机制尚不清楚。因此,我们通过在三组离体灌注的正常大鼠肺中独立改变这些参数,研究了肺血管压力和流量(Q(p))的改变对气道和实质力学特性的影响。在恒定Q(p)(n = 7)时增加根据肺动脉(Ppa)和左心房压力(Pla)估算的肺毛细血管压力(Pc(est)),或者在Pc(est) = 10 mmHg(n = 7)和Pc(est) = 20 mmHg(n = 6)时改变Q(p)。在每种情况下,从低频肺输入阻抗谱中确定气道阻力(Raw)、实质阻尼(G)和弹性(H)。分析了在等重力条件下进行的测量结果。在力学参数中观察到的变化与Pla的改变一致:随着Pla增加,Raw单调增加,而G和H在Pla约为7 - 10 mmHg时最小,在较低和较高的Pla时增加。结果表明,在肺血流动力学急性改变后,Pla而非Ppa或Q(p)是肺力学状态的主要决定因素:如果Pla低于或高于生理值,实质力学受损,而在高Pla时会出现气道狭窄。

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