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新生儿缺氧性通气抑制期间膈肌肌电图升高

Elevated diaphragm electromyogram during neonatal hypoxic ventilatory depression.

作者信息

LaFramboise W A, Woodrum D E

出版信息

J Appl Physiol (1985). 1985 Oct;59(4):1040-5. doi: 10.1152/jappl.1985.59.4.1040.

DOI:10.1152/jappl.1985.59.4.1040
PMID:2997107
Abstract

Diaphragmatic electromyogram (EMG) was obtained in eight 48-h-old unanesthetized monkeys while breathing air and then either of two different hypoxic gas mixtures (12 or 8% O2 in N2) for 5 min. Minute ventilation (VI) rose significantly above control levels by 1 min of hypoxemia while animals were breathing either of the hypoxic gas mixtures as tidal volume (VT) and slope and rate moving average EMG increased. The relative gains in VI were associated with comparable increases in diaphragmatic neural activity per minute (EMG/min = peak EMG X frequency) during this early phase of hypoxemia. VI subsequently fell to control levels (inspired O2 fraction = 12%, arterial PO2 = 23 +/- 3 Torr) or significantly below (inspired O2 fraction = 8%, arterial PO2 = 18 +/- 0.4 Torr) by 5 min of hypoxemia, secondary to changes in VT. Despite the decline in VI, slope and rate moving average EMG, and EMG/min remained statistically above control values by 5 min of hypoxemia, although there was a trend for EMG/min to decrease slightly from the 1-min peak response. These findings demonstrate that hypoxic-induced depression of neural input to the diaphragm is not independently responsible for the biphasic nature of the newborn ventilatory response, although it cannot be ruled out as a contributor. The fall in inspiratory volumes despite constant elevated EMG activity suggests the presence of a change in respiratory mechanics and/or an impairment in diaphragmatic contractile function without offsetting neural compensatory activity.

摘要

在八只48小时大未麻醉的猴子呼吸空气时记录膈肌肌电图(EMG),然后让它们呼吸两种不同的低氧混合气体(氮气中含12%或8%氧气)5分钟。低氧血症1分钟时,当动物呼吸任何一种低氧混合气体时,分钟通气量(VI)显著高于对照水平,同时潮气量(VT)以及斜率和速率移动平均EMG均增加。在低氧血症的早期阶段,VI的相对增加与每分钟膈肌神经活动的相应增加相关(EMG/分钟=峰值EMG×频率)。随后,低氧血症5分钟时,VI降至对照水平(吸入氧分数=12%,动脉血氧分压=23±3托)或显著低于对照水平(吸入氧分数=8%,动脉血氧分压=18±0.4托),这是VT变化的继发结果。尽管VI下降,但低氧血症5分钟时,斜率和速率移动平均EMG以及EMG/分钟在统计学上仍高于对照值,尽管EMG/分钟有从1分钟时的峰值反应略有下降的趋势。这些发现表明,低氧诱导的膈肌神经输入抑制并非新生儿通气反应双相性质的独立原因,尽管不能排除其作为一个促成因素。尽管EMG活动持续升高,但吸气量下降,这表明呼吸力学发生了变化和/或膈肌收缩功能受损,且没有神经代偿活动的抵消。

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