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吸气性高频气道振荡可减轻年轻健康个体的阻力负荷性呼吸困难并调节呼吸功能。

Inspiratory high frequency airway oscillation attenuates resistive loaded dyspnea and modulates respiratory function in young healthy individuals.

作者信息

Morris Theresa, Sumners David Paul, Green David Andrew

机构信息

Centre of Human & Aerospace Physiological Sciences, King's College London, London, United Kingdom.

Applied Science, Engineering, Science and the Built Environment, London South Bank University, London, United Kingdom.

出版信息

PLoS One. 2014 Mar 20;9(3):e91291. doi: 10.1371/journal.pone.0091291. eCollection 2014.

Abstract

Direct chest-wall percussion can reduce breathlessness in Chronic Obstructive Pulmonary Disease and respiratory function may be improved, in health and disease, by respiratory muscle training (RMT). We tested whether high-frequency airway oscillation (HFAO), a novel form of airflow oscillation generation can modulate induced dyspnoea and respiratory strength and/or patterns following 5 weeks of HFAO training (n = 20) compared to a SHAM-RMT (conventional flow-resistive RMT) device (n = 15) in healthy volunteers (13 males; aged 20-36 yrs). HFAO causes oscillations with peak-to-peak amplitude of 1 cm H2O, whereas the SHAM-RMT device was identical but created no pressure oscillation. Respiratory function, dyspnoea and ventilation during 3 minutes of spontaneous resting ventilation, 1 minute of maximal voluntary hyperventilation and 1 minute breathing against a moderate inspiratory resistance, were compared PRE and POST 5-weeks of training (2 × 30 breaths at 70% peak flow, 5 days a week). Training significantly reduced NRS dyspnoea scores during resistive loaded ventilation, both in the HFAO (p = 0.003) and SHAM-RMT (p = 0.005) groups. Maximum inspiratory static pressure (cm H2O) was significantly increased by HFAO training (vs. PRE; p<0.001). Maximum inspiratory dynamic pressure was increased by training in both the HFAO (vs. PRE; p<0.001) and SHAM-RMT (vs. PRE; p = 0.021) groups. Peak inspiratory flow rate (L.s(-1)) achieved during the maximum inspiratory dynamic pressure manoeuvre increased significantly POST (vs. PRE; p = 0.001) in the HFAO group only. HFAO reduced inspiratory resistive loading-induced dyspnoea and augments static and dynamic maximal respiratory manoeuvre performance in excess of flow-resistive IMT (SHAM-RMT) in healthy individuals without the respiratory discomfort associated with RMT.

摘要

直接胸壁叩击可减轻慢性阻塞性肺疾病患者的呼吸困难,呼吸肌训练(RMT)在健康状态和患病状态下均可改善呼吸功能。我们测试了高频气道振荡(HFAO)这种新型气流振荡产生形式,在健康志愿者(13名男性,年龄20 - 36岁)中,与假RMT(传统的流阻式RMT)设备(n = 15)相比,经过5周HFAO训练(n = 20)后是否能调节诱发的呼吸困难以及呼吸强度和/或模式。HFAO产生峰 - 峰值幅度为1 cm H₂O的振荡,而假RMT设备与之相同但不产生压力振荡。在5周训练前后(每周5天,以70%峰值流量进行2×30次呼吸),比较了在3分钟自主静息通气、1分钟最大自主过度通气和1分钟对抗中度吸气阻力呼吸过程中的呼吸功能、呼吸困难和通气情况。训练显著降低了两组在阻力负荷通气期间的数字评分量表(NRS)呼吸困难评分,HFAO组(p = 0.003)和假RMT组(p = 0.005)均是如此。HFAO训练使最大吸气静态压力(cm H₂O)显著增加(与训练前相比;p<0.001)。HFAO组(与训练前相比;p<0.001)和假RMT组(与训练前相比;p = 0.021)的最大吸气动态压力均因训练而增加。仅在HFAO组中,最大吸气动态压力操作期间达到的峰值吸气流量率(L·s⁻¹)在训练后显著增加(与训练前相比;p = 0.001)。在健康个体中,HFAO减轻了吸气阻力负荷诱发的呼吸困难,增强了静态和动态最大呼吸操作表现,超过了流阻式IMT(假RMT),且没有RMT相关的呼吸不适。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d71/3961233/288b27b647fc/pone.0091291.g001.jpg

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