Agostoni Emilio, Zocchi Luciano
Istituto di Fisiologia Umana I, Università di Milano, Via Mangiagalli 32, 20133, Milano, Italy.
Respir Physiol Neurobiol. 2007 Dec 15;159(3):311-23. doi: 10.1016/j.resp.2007.07.002. Epub 2007 Jul 22.
After an account on morphological features of visceral and parietal pleura, mechanical coupling between lung and chest wall is outlined. Volume of pleural liquid is considered along with its thickness in various regions, and its composition. Pleural liquid pressure (P(liq)) and pressure exerted by lung recoil in various species and postures are then compared, and the vertical gradient of P(liq) considered. Implications of lower P(liq) in the lung zone than in the costo-phrenic sinus at iso-height are pointed out. Mesothelial permeability to H(2)O, Cl(-), Na(+), mannitol, sucrose, inulin, albumin, and various size dextrans is provided, along with paracellular "pore" radius of mesothelium. Pleural liquid is produced by filtration from parietal pleura capillaries according to Starling forces. It is removed by absorption in visceral pleura capillaries according to Starling forces (at least in some species), lymphatic drainage through stomata of parietal mesothelium (essential to remove cells, particles, and large macromolecules), solute-coupled liquid absorption, and transcytosis through mesothelium.
在阐述了脏层胸膜和壁层胸膜的形态学特征之后,概述了肺与胸壁之间的机械耦合。研究了胸膜液的体积及其在不同区域的厚度和成分。然后比较了不同物种和姿势下胸膜液压力(P(liq))和肺回缩所施加的压力,并考虑了P(liq)的垂直梯度。指出了在等高度时肺区的P(liq)低于肋膈窦的意义。给出了间皮对H(2)O、Cl(-)、Na(+)、甘露醇、蔗糖、菊粉、白蛋白和各种大小右旋糖酐的通透性,以及间皮的细胞旁“孔”半径。胸膜液是根据Starling力从壁层胸膜毛细血管滤过产生的。它通过根据Starling力在内脏胸膜毛细血管中的吸收(至少在某些物种中)、通过壁层间皮气孔的淋巴引流(对于清除细胞、颗粒和大分子至关重要)、溶质耦合的液体吸收以及通过间皮的转胞吞作用而被清除。