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在自主呼吸和非自主呼吸过程中人类肋部和膈脚部膈肌的差异激活。

Differential activation of the human costal and crural diaphragm during voluntary and involuntary breaths.

作者信息

Nguyen D A T, Amirjani N, McCaughey E J, Gandevia S C, Butler J E, Hudson A L

机构信息

Neuroscience Research Australia, and University of New South Wales, Sydney, New South Wales, Australia.

Northern Alberta EMG and Neuromuscular Clinic, Alberta, Canada.

出版信息

J Appl Physiol (1985). 2020 May 1;128(5):1262-1270. doi: 10.1152/japplphysiol.00790.2019. Epub 2020 Mar 12.

Abstract

The diaphragm is the primary muscle that generates the negative intrathoracic pressure to drive inspiratory airflow. The diaphragm consists of two parts, the costal and crural portions, with different roles during inspiration in animals, particularly when the stimulus to breathe is increased. In this study, the neural drive to the costal and crural portions of the diaphragm was assessed in nine healthy participants [8 male, aged 32 ± 13 yr (mean ± SD)]. Inspiratory electromyographic activity (EMG) was recorded from the costal diaphragm by using an intramuscular electrode and from the crural diaphragm with a multipair gastroesophageal catheter. Participants performed voluntary augmented breaths at 120%, 140%, and 160% of their tidal volume and also underwent progressive hypercapnia to induce involuntary breathing. Irrespective of the task, the increase in crural activity (normalized to quiet breathing) was only ~60% of the increase in costal activity (slope: 0.56 ± 0.30, < 0.001). The onset and peak timing of EMG activity was similar for the costal and crural diaphragm during quiet breathing. Thus, when stimulated by either a voluntary or involuntary drive to breathe above tidal volume, the neural drive to the diaphragm was greater to the costal than to the crural portion. Simultaneous electromyographic recordings from the human costal and crural diaphragm during voluntary augmented breathing and involuntary rebreathing show that the increase in inspiratory crural diaphragm activity was ~60% of the increase in costal diaphragm activity. However costal to crural diaphragm activation did not differ between the two tasks. The dissociation in the amplitude of activation of the costal and crural diaphragm becomes apparent only as the drive to breathe increases above tidal breathing.

摘要

横膈膜是产生胸腔内负压以驱动吸气气流的主要肌肉。横膈膜由两部分组成,即肋部和脚部,在动物吸气过程中发挥着不同作用,尤其是在呼吸刺激增加时。在本研究中,对9名健康参与者[8名男性,年龄32±13岁(均值±标准差)]的横膈膜肋部和脚部的神经驱动进行了评估。通过肌内电极记录肋横膈膜的吸气肌电图活动(EMG),并使用多对胃食管导管记录脚横膈膜的活动。参与者以潮气量的120%、140%和160%进行主动深吸气,并且还进行渐进性高碳酸血症以诱导不自主呼吸。无论任务如何,脚部活动的增加(相对于安静呼吸进行标准化)仅为肋部活动增加的约60%(斜率:0.56±0.30,P<0.001)。安静呼吸时,肋横膈膜和脚横膈膜的EMG活动的起始和峰值时间相似。因此,当受到高于潮气量的主动或不自主呼吸驱动刺激时,横膈膜的神经驱动对肋部的作用比对脚部的作用更大。在主动深吸气和不自主重复呼吸期间同时记录人体肋横膈膜和脚横膈膜的肌电图显示,吸气时脚横膈膜活动的增加约为肋横膈膜活动增加的60%。然而,这两项任务中肋横膈膜与脚横膈膜的激活并无差异。仅当呼吸驱动增加至高于潮式呼吸时,肋横膈膜和脚横膈膜激活幅度的分离才变得明显。

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