Onal E, Lopata M
J Appl Physiol (1985). 1986 Nov;61(5):1891-5. doi: 10.1152/jappl.1986.61.5.1891.
To study respiratory muscle interaction in patients with occlusive apnea, diaphragmatic electromyogram (EMGdi) and gastric, pleural, and transdiaphragmatic pressures (Pga, Ppl, and Pdi, respectively) were studied in seven patients during non-rapid-eye-movement (NREM) sleep. Diaphragmatic force output, as assessed by Pdi, followed the periodic changes in EMGdi but during the occlusive phase the increase in Pdi was more than the increase in EMGdi. This increase in Pdi was essentially due to an increase in Ppl, since Pga and EMGdi had a linear relationship (r = 0.98, P less than 0.001) that did not change during the occlusive and ventilatory phases. Abdominal muscle recruitment evident in Pga and abdominal motion tracings during the occlusive phase when paradoxical rib cage motion was observed suggested that this increase in diaphragmatic efficiency was likely due to a change in diaphragmatic length-tension characteristics. These results demonstrate that, in patients with occlusive apneas, the diaphragm is the predominant respiratory muscle during NREM sleep and that its function is supported by abdominal muscle recruitment.
为研究阻塞性呼吸暂停患者的呼吸肌相互作用，在7例患者非快速眼动（NREM）睡眠期间，对其膈肌肌电图（EMGdi）以及胃内压、胸膜腔压和跨膈压（分别为Pga、Ppl和Pdi）进行了研究。通过Pdi评估的膈肌力输出跟随EMGdi的周期性变化，但在阻塞期，Pdi的增加幅度大于EMGdi的增加幅度。Pdi的这种增加主要归因于Ppl的增加，因为Pga与EMGdi呈线性关系（r = 0.98，P < 0.001），且在阻塞期和通气期均未改变。在观察到矛盾性胸廓运动的阻塞期，Pga和腹部运动描记图中明显出现腹部肌肉募集，这表明膈肌效率的这种增加可能是由于膈肌长度 - 张力特性的改变。这些结果表明，在阻塞性呼吸暂停患者中，膈肌是NREM睡眠期间的主要呼吸肌，其功能得到腹部肌肉募集的支持。
