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膈肌激活增加对膈肌功率谱中心频率的影响。

Effect of increased diaphragm activation on diaphragm power spectrum center frequency.

作者信息

Spahija Jadranka, Beck Jennifer, Lindström Lars, Bégin Paul, de Marchie Michel, Sinderby Christer

机构信息

Research Center, Respiratory Health Research Unit, Sacré-Coeur Hospital of Montréal, Montreal, Que., Canada H4J 1C5.

出版信息

Respir Physiol Neurobiol. 2005 Mar;146(1):67-76. doi: 10.1016/j.resp.2004.11.006.

Abstract

Increased transdiaphragmatic pressure, reduced muscle blood flow, and increased duty cycle have all been associated with a reduction in the center frequency (CFdi) of the diaphragm's electrical activity (EAdi). However, the specific influence of diaphragm activation on CFdi is unknown. We evaluated whether increased diaphragm activation would result in a greater decline in the CFdi when pressure-time product (PTPdi) was kept constant. Five healthy subjects performed periods of intermittent quasi-static diaphragmatic contractions with a fixed duty cycle. In separate runs, subjects targeted transdiaphragmatic pressures (Pdi) by performing end-inspiratory holds with the glottis open and expulsive maneuvers at end-expiratory lung volume (EELV). Diaphragm activation and pressures were measured with an electrode array and balloons mounted on an esophago-gastric catheter, respectively. The EAdi, which was 25+/-8%(S.D.) of maximum at EELV, increased to 61+/-8% (P<0.001) when an identical Pdi (averaging 31+/-13 cmH2O) was generated at a higher lung volume (77% of inspiratory capacity). The latter was associated with a 17% greater decline in CFdi (P=0.012). In order to reproduce at EELV, the decrease in CFdi observed at the increased lung volume, a two-fold increase in PTPdi was required. We conclude that CFdi responds specifically to increased diaphragm activation when pressure-time product remains constant.

摘要

跨膈压升高、肌肉血流减少以及占空比增加均与膈肌电活动(EAdi)的中心频率(CFdi)降低有关。然而,膈肌激活对CFdi的具体影响尚不清楚。我们评估了在压力 - 时间乘积(PTPdi)保持恒定的情况下,增加膈肌激活是否会导致CFdi更大程度的下降。五名健康受试者以固定的占空比进行间歇性准静态膈肌收缩。在不同的试验中,受试者通过在声门开放时进行吸气末屏气以及在呼气末肺容积(EELV)时进行呼气动作来设定跨膈压(Pdi)。分别使用电极阵列和安装在食管 - 胃导管上的气囊测量膈肌激活和压力。在EELV时,EAdi为最大值的25±8%(标准差),当在较高肺容积(吸气容量的77%)产生相同的Pdi(平均31±13 cmH₂O)时,EAdi增加到61±8%(P<0.001)。后者与CFdi下降幅度大17%相关(P = 0.012)。为了在EELV时重现肺容积增加时观察到的CFdi下降,需要将PTPdi增加两倍。我们得出结论,当压力 - 时间乘积保持恒定时,CFdi对增加的膈肌激活有特异性反应。

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