Kinnear W, Higenbottam T, Shaw D, Wallwork J, Estenne M
Department of Respiratory Physiology, Papworth Hospital, Huntingdon, U.K.
Respir Physiol. 1989 Jul;77(1):75-88. doi: 10.1016/0034-5687(89)90031-5.
We have studied the contribution of vagal pulmonary receptors to the stability of breathing during postural changes in humans. Quiet breathing was quantified in the seated and the supine postures in 10 patients with chronic pulmonary denervation due to heart-lung transplantation and 10 age and sex matched normal controls. In the vast majority of patients and normal subjects frequency histograms for tidal volume and mean inspiratory flow rate were virtually superimposed seated and supine. There were no significant differences in the mean levels of respiratory variables between postures in either group (except for mean inspiratory flow rate in the patients which was slightly greater seated than supine). Experiments performed on a tilt table in two additional patients showed that the ventilatory response to postural changes was immediate. In addition, the response was maintained after blockade of intact tracheal stretch receptors with aerosolized lidocaine. These results indicate that adequate ventilatory compensation during postural changes does not depend on vagal afferent information arising in intrapulmonary or tracheal airway stretch receptors. The appropriate receptors may be diaphragmatic Golgi tendon organs.
我们研究了迷走神经肺受体对人类姿势改变时呼吸稳定性的作用。对10例因心肺移植导致慢性肺去神经支配的患者及10名年龄和性别相匹配的正常对照者，分别测定了坐位和仰卧位时的静息呼吸情况。绝大多数患者和正常受试者的潮气量和平均吸气流量频率直方图在坐位和仰卧位时几乎重叠。两组中不同姿势下呼吸变量的平均水平均无显著差异（患者组中平均吸气流量除外，坐位时略高于仰卧位）。另外对2例患者在倾斜台上进行的实验表明，对姿势改变的通气反应是即刻的。此外，用雾化利多卡因阻断完整的气管牵张感受器后，该反应仍持续存在。这些结果表明，姿势改变时充分的通气补偿并不依赖于肺内或气管气道牵张感受器产生的迷走传入信息。合适的感受器可能是膈肌高尔基腱器官。
