Fleury B, Housset B, Kulpa M, Derenne J P
Rev Mal Respir. 1985;2(4):199-203.
During the course of chronic airflow obstruction the effect of the pathological process and compensatory mechanisms that take place in the lungs to limit these effects express themselves by easily indentifiable clinical signs. The limitations of expiratory flow is responsible for the prolongation of the duration of maximal expiration: Pursed lipped breathing is probably the method used by certain patients to limit airway collapse; the increase in the residual volume and functional residual capacity results in distortion of the thorax and a change in the configuration of the inspiratory muscles, reducing their capacity to generate pressures (Hoover's sign: respiratory pulse, hypertrophy of the accessory respiratory muscles, thoraco-abdominal asynchrony); the considerable increase in the inspiratory thoracic depression accounts for the inspiratory descent of the trachea and the sub-sternal "tug". Finally the ventilatory pattern is different, ventilation being rapid and superficial, probably in order to adapt to the constraints imposed by the pathological process.
在慢性气流阻塞过程中，肺部发生的病理过程及代偿机制的作用（这些机制旨在限制气流阻塞的影响）通过易于识别的临床体征表现出来。呼气气流受限导致最大呼气时间延长：某些患者可能采用缩唇呼吸的方法来限制气道塌陷；残气量和功能残气量增加导致胸廓变形以及吸气肌形态改变，降低了它们产生压力的能力（胡佛征：呼吸性脉搏、辅助呼吸肌肥大、胸腹不同步）；吸气时胸廓明显凹陷导致气管吸气时下移以及胸骨下“牵拉”。最后，通气模式有所不同，通气变得快速且浅表，这可能是为了适应病理过程所带来的限制。
