Nagase T, Lei M, Robatto F M, Eidelman D H, Ludwig M S
Meakins-Christie Laboratories, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada.
J Appl Physiol (1985). 1992 Nov;73(5):1900-7. doi: 10.1152/jappl.1992.73.5.1900.
Tissue viscance (Vti), the pressure drop across the lung tissues in phase with flow, increases after induced constriction. To gain information about the possible site of response, we induced increases in Vti with methacholine (MCh) and attempted to correlate these changes with alterations in lung morphology. We measured tracheal (Ptr) and alveolar pressure (PA) in open-chest rabbits during mechanical ventilation [frequency = 1 Hz, tidal volume = 5 ml/kg, positive end-expiratory pressure (PEEP) = 5 cmH2O] under control conditions and after administration of saline or MCh (32 or 128 mg/ml) aerosols. We calculated lung elastance (EL), lung resistance (RL), Vti, and airway resistance (Raw) by fitting the equation of motion to changes in Ptr and PA. The lungs were then frozen in situ with liquid nitrogen (PEEP = 5 cmH2O), excised, and processed using freeze substitution techniques. Airway constriction was assessed by measuring the ratio of the airway lumen (A) to the ideally relaxed area (Ar). Tissue distortion was assessed by measuring the mean linear intercept between alveolar walls (Lm), the standard deviation of Lm (SDLm), and an atelectasis index (ATI) derived by calculating the ratio of tissue to air space using computer image analysis. RL, Vti, and EL were significantly increased after MCh, and Raw was unchanged. A/Ar, Lm, SDLm, and ATI all changed significantly with MCh. Log-normalized change (% of baseline) in Vti significantly correlated with A/Ar (r = -0.693), Lm (r = 0.691), SDLm (r = 0.648), and ATI (r = 0.656). Hence, changes in lung tissue mechanics correlated with changes in morphometric indexes of parenchymal distortion and airway constriction.(ABSTRACT TRUNCATED AT 250 WORDS)
组织黏性(Vti),即与血流同步的肺组织两端的压力差,在诱导性收缩后会增加。为了获取有关可能的反应位点的信息,我们用乙酰甲胆碱(MCh)诱导Vti升高,并试图将这些变化与肺形态学改变相关联。我们在机械通气期间[频率 = 1赫兹,潮气量 = 5毫升/千克,呼气末正压(PEEP)= 5厘米水柱],对开胸兔在对照条件下以及给予生理盐水或MCh(32或128毫克/毫升)气雾剂后,测量气管压力(Ptr)和肺泡压力(PA)。我们通过将运动方程拟合到Ptr和PA的变化来计算肺弹性(EL)、肺阻力(RL)、Vti和气道阻力(Raw)。然后用液氮将肺原位冷冻(PEEP = 5厘米水柱),切除并使用冷冻置换技术进行处理。通过测量气道管腔(A)与理想松弛面积(Ar)的比值来评估气道收缩。通过测量肺泡壁之间的平均线性截距(Lm)、Lm的标准差(SDLm)以及使用计算机图像分析通过计算组织与气腔的比值得出的肺不张指数(ATI)来评估组织变形。MCh给药后,RL、Vti和EL显著升高,而Raw未改变。A/Ar、Lm、SDLm和ATI均随MCh发生显著变化。Vti的对数归一化变化(相对于基线的百分比)与A/Ar(r = -0.693)、Lm(r = 0.691)、SDLm(r = 0.648)和ATI(r = 0.656)显著相关。因此,肺组织力学变化与实质变形和气道收缩的形态计量学指标变化相关。(摘要截断于250字)