Ferguson G T, Irvin C G, Cherniack R M
Department of Medicine, National Jewish Center for Immunology and Respiratory Medicine, Denver, Colorado 80206.
Am Rev Respir Dis. 1990 Jan;141(1):156-63. doi: 10.1164/ajrccm/141.1.156.
The effects of corticosteroid administration for 2 weeks on diaphragm histology, biochemistry, and function were assessed in the rabbit at rest and during inspiratory loading to respiratory failure, and compared to the extensor digitorum longus and untreated control animals. There were marked pathologic changes in the diaphragm after corticosteroid administration and significant alterations in diaphragm glycogen level (118.7 +/- 2.8 versus 56.2 +/- 1.0 mmol/kg wet weight, p less than 0.01) and lactate level (5.3 +/- 0.3 versus 3.5 +/- 0.4 mmol/kg wet weight, p less than 0.01) with only minimal changes in the skeletal muscle. Although respiratory muscle endurance in the control group increased from 142 +/- 17 min at baseline to 155 +/- 20 at Week 1 and 183 +/- 13 at Week 2 (p less than 0.05), it fell progressively from 135 +/- 19 min at baseline to 99 +/- 5 at Week 1 and 88 +/- 9 at Week 2 (p less than 0.01) in the corticosteroid-treated animals. On the other hand, there was no significant change in resting Pdimax after corticosteroid administration. In addition, there was no significant change in Pdimax, Pdi/Edi ratio, or glycogen level at the point of respiratory failure, but diaphragm lactate levels were increased (8.5 +/- 0.8 versus 5.3 +/- 0.3, p less than 0.05). When variable degrees of diaphragm dysfunction were induced by phrenic nerve pacing and/or thoracoabdominal binding, the degree of biochemical change associated with diaphragm dysfunction was significantly greater in corticosteroid-treated animals. We conclude that corticosteroid administration in the rabbit alters diaphragm histopathology and biochemistry as well as respiratory muscle endurance, but not strength.(ABSTRACT TRUNCATED AT 250 WORDS)
在兔处于静息状态以及吸气负荷至呼吸衰竭期间,评估了给予皮质类固醇2周对膈肌组织学、生物化学及功能的影响,并与趾长伸肌及未治疗的对照动物进行比较。给予皮质类固醇后,膈肌出现明显的病理变化,膈肌糖原水平(118.7±2.8对56.2±1.0 mmol/kg湿重,p<0.01)和乳酸水平(5.3±0.3对3.5±0.4 mmol/kg湿重,p<0.01)有显著改变,而骨骼肌仅有微小变化。虽然对照组呼吸肌耐力从基线时的142±17分钟增加至第1周的155±20分钟和第2周的183±13分钟(p<0.05),但在接受皮质类固醇治疗的动物中,呼吸肌耐力从基线时的135±19分钟逐渐降至第1周的99±5分钟和第2周的88±9分钟(p<0.01)。另一方面,给予皮质类固醇后静息最大跨膈压无显著变化。此外,在呼吸衰竭时,最大跨膈压、跨膈压与膈肌电活动比值或糖原水平无显著变化,但膈肌乳酸水平升高(8.5±0.8对5.3±0.3,p<0.05)。当通过膈神经起搏和/或胸腹捆绑诱导不同程度的膈肌功能障碍时,与膈肌功能障碍相关的生化变化程度在接受皮质类固醇治疗的动物中显著更大。我们得出结论,兔给予皮质类固醇会改变膈肌组织病理学、生物化学以及呼吸肌耐力,但不会改变肌力。(摘要截短于250字)