Department of Cardiology and Pneumology, University Hospital Goettingen, Robert-Koch-Strasse 40, D-37075 Goettingen, Germany.
Respir Med. 2010 Jan;104(1):107-13. doi: 10.1016/j.rmed.2009.06.011. Epub 2009 Jul 19.
Neurohumoral activation has been shown to be present in patients with chronic obstructive pulmonary disease (COPD). The increase in respiratory muscle work might be responsible for the observed elevation of sympathetic tone via a respiratory muscle ergoreflex in these patients. The aim of this study is to investigate whether moderately increasing inspiratory resistive loading will impact on sympathetic activity in healthy subjects and COPD patients.
Efferent muscle sympathetic nerve activity, blood pressure, heart rate and respiratory movements were continuously measured in 15 patients and 15 healthy control subjects. In order to increase work of breathing as evaluated by the tension-time index, inspiratory resistive loading was performed while patients were breathing through a spirometer.
At baseline, sympathetic nerve activity was significantly elevated in patients. Resistive loading increased work of breathing (tension-time index) by roughly 110% (COPD) and 130% (controls) but did not significantly alter blood gases or sympathetic activity in either group.
Doubling the work of breathing does not affect sympathetic activation in COPD patients or healthy control subjects. Thus in COPD the respiratory muscle ergoreflex does not seem to play a major role in sympathoexcitation.
神经体液激活已被证明存在于慢性阻塞性肺疾病（COPD）患者中。呼吸肌做功的增加可能通过这些患者的呼吸肌张力反射导致观察到的交感神经张力升高。本研究的目的是研究在健康受试者和 COPD 患者中，适度增加吸气阻力负荷是否会对交感活性产生影响。
连续测量了 15 例患者和 15 例健康对照组的传出肌交感神经活动、血压、心率和呼吸运动。为了通过张力时间指数评估增加呼吸功，在患者通过肺活量计呼吸时进行吸气阻力负荷。
在基线时，患者的交感神经活动明显升高。阻力负荷使呼吸功增加（张力时间指数），在 COPD 患者中约增加 110%，在对照组中约增加 130%，但在两组中均未显著改变血气或交感神经活性。
使呼吸功增加一倍不会影响 COPD 患者或健康对照组的交感神经激活。因此，在 COPD 中，呼吸肌张力反射似乎在交感神经兴奋中不起主要作用。
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