Boriek Aladin M, Black Ben, Hubmayr Rolf, Wilson Theodore A
Dept. of Medicine, Pulmonary Section, Baylor College of Medicine, Houston, TX 77030, USA.
J Appl Physiol (1985). 2006 Sep;101(3):794-8. doi: 10.1152/japplphysiol.00865.2004.
Transdiaphragmatic pressure is a result of both tension in the muscles of the diaphragm and curvature of the muscles. As lung volume increases, the pressure-generating capability of the diaphragm decreases. Whether decrease in curvature contributes to the loss in transdiaphragmatic pressure and, if so, under what conditions it contributes are unknown. Here we report data on muscle length and curvature in the supine dog. Radiopaque markers were attached along muscle bundles in the midcostal region of the diaphragm in six beagle dogs of approximately 8 kg, and marker locations were obtained from biplanar images at functional residual capacity (FRC), during spontaneous inspiratory efforts against a closed airway at lung volumes from FRC to total lung capacity, and during bilateral maximal phrenic nerve stimulation at the same lung volumes. Muscle length and curvature were obtained from these data. During spontaneous inspiratory efforts, muscle shortened by 15-40% of length at FRC, but curvature remained unchanged. During phrenic nerve stimulation, muscle shortened by 30 to nearly 50%, and, for shortening exceeding 52%, curvature appeared to decrease sharply. We conclude that diaphragm curvature is nearly constant during spontaneous breathing maneuvers in normal animals. However, we speculate that it is possible, if lung compliance were increased and the chest wall and the diameter of the diaphragm ring of insertion were enlarged, as in the case of chronic obstructive pulmonary disease, that decrease in diaphragm curvature could contribute to loss of diaphragm function.
跨膈压是膈肌肌肉张力和肌肉曲率共同作用的结果。随着肺容积增加,膈肌产生压力的能力下降。曲率的降低是否导致跨膈压的损失,如果是,在何种情况下导致这种损失尚不清楚。在此,我们报告了关于仰卧位犬膈肌肌肉长度和曲率的数据。在6只体重约8kg的比格犬的膈肌肋缘中部区域,沿着肌束附着不透X线的标记物,并在功能残气量(FRC)、从FRC到肺总量的肺容积下对抗封闭气道进行自主吸气努力期间以及在相同肺容积下进行双侧最大膈神经刺激期间,从双平面图像中获取标记物位置。从这些数据中得出肌肉长度和曲率。在自主吸气努力期间,肌肉长度缩短了FRC时长度的15 - 40%,但曲率保持不变。在膈神经刺激期间,肌肉缩短了30%至近50%,并且当缩短超过52%时,曲率似乎急剧下降。我们得出结论,在正常动物的自主呼吸过程中,膈肌曲率几乎是恒定的。然而,我们推测,如果肺顺应性增加且胸壁和膈肌插入环的直径增大,如在慢性阻塞性肺疾病的情况下,膈肌曲率的降低可能导致膈肌功能丧失。