Mlczoch J, Kummer F
Acta Med Austriaca. 1979;6(2):67-71.
Changes in pulmonary function have been reported in patients after uncomplicated myocardial infarction, with reduction in lung volumes and flow rates. The significant increase in oscillatory resistance and impedance of the lung, was seen on the first day after myocardial infarction. The application of ipratropiumbromid, an anticholinergic broncholytic agent, significantly decreased oscillatory resistance and impedance, on the first day, but not to the same extent, after the fourth day. The reduction of oscillatory resistance and impedance could be attributed to blockade of a vagal mediated bronchoconstriction, which predominantly affects the small airways. The observed changes in pulmonary function, could therefore not only be due to congestion with increase in extravascular pulmonary fluid, but in the acute phase of myocardial infarction, also due to a reflex mechanism in which vagal mediated bronchoconstriction is demonstrated.
据报道，无并发症心肌梗死患者的肺功能会发生变化，肺容积和流速降低。心肌梗死后第一天，肺的振荡阻力和阻抗显著增加。抗胆碱能支气管扩张剂异丙托溴铵在第一天可显著降低振荡阻力和阻抗，但在第四天之后，降低程度不同。振荡阻力和阻抗的降低可能归因于迷走神经介导的支气管收缩的阻断，这种收缩主要影响小气道。因此，观察到的肺功能变化不仅可能是由于血管外肺液增加导致的充血，还可能是由于心肌梗死急性期的一种反射机制，其中表现出迷走神经介导的支气管收缩。
