Yamamoto Fumiko, Nishino Takashi
Department of Anesthesiology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Am J Respir Crit Care Med. 2002 May 15;165(10):1400-3. doi: 10.1164/rccm.2108075.
We investigated the effects of sudden changes in ventilation induced by voluntary hyperpnea and breath-holding on repetitive reflex swallowing elicited by continuous infusion of distilled water into the pharynx in 13 healthy subjects. Ventilation was monitored using a pneumotachograph, and swallowing was identified by submental electromyography with interruption of airflow. We found that voluntary hyperpnea decreased the swallowing frequency whether end-tidal CO(2) tension was maintained at normocapnia or allowed to be hypocapnic. Also, the frequency of swallowing immediately increased with the start of breath-holding, but there was a sudden decrease in swallowing frequency during the hyperpnea observed immediately after the resumption of ventilation (post-breath-holding hyperpnea). The preponderant coupling of swallows with the expiratory phase was lost during voluntary hyperpnea but was maintained during post-breath-holding hyperpnea. These observations may suggest that vagally mediated reflexes are operative in normal physiologic situations and play an important role in the control of swallowing rate as well as in the timing of swallowing in reference to the respiratory cycle.
我们研究了13名健康受试者在自愿进行深呼吸和屏气所诱发的通气突然变化时，咽部持续输注蒸馏水所引发的重复性反射性吞咽的影响。使用呼吸流速仪监测通气情况，并通过颏下肌电图结合气流中断来识别吞咽。我们发现，无论终末潮气二氧化碳分压维持在正常碳酸水平还是处于低碳酸状态，自愿深呼吸都会降低吞咽频率。此外，屏气开始时吞咽频率立即增加，但在恢复通气后紧接着出现的深呼吸（屏气后深呼吸）过程中，吞咽频率突然下降。在自愿深呼吸期间，吞咽与呼气阶段的优势耦合消失，但在屏气后深呼吸期间得以维持。这些观察结果可能表明，迷走神经介导的反射在正常生理情况下起作用，并且在吞咽速率的控制以及与呼吸周期相关的吞咽时机方面发挥重要作用。
