Henke K G, Sharratt M, Pegelow D, Dempsey J A
John Rankin Laboratory of Pulmonary Medicine, Department of Preventive Medicine, University of Wisconsin Medical School, Madison 53705.
J Appl Physiol (1985). 1988 Jan;64(1):135-46. doi: 10.1152/jappl.1988.64.1.135.
We determined the effects of exercise on active expiration and end-expiratory lung volume (EELV) during steady-state exercise in 13 healthy subjects. We also addressed the questions of what affects active expiration during exercise. Exercise effects on EELV were determined by a He-dilution technique and verified by changes in end-expiratory esophageal pressure. We also used abdominal pressure-volume loops to determine active expiration. EELV was reduced with increasing exercise intensity. EELV was reduced significantly during even mild steady-state exercise and during heavy exercise decreased an average of 0.71 +/- 0.3 liter. Dynamic lung compliance was reduced 30-50%; EELV remained greater than closing volume. Changing the resistance to airflow (via SF6-O2 or He-O2 breathing) during steady-state exercise changed the peak gastric and esophageal pressure generation during expiration but did not alter EELV; breathing through the mouthpiece produced similar effects during exercise. EELV was significantly reduced in the supine position. With supine exercise active expiration was not elicited, and EELV remained the same as in supine rest. With CO2-driven hyperpnea (7-70 l/min), EELV remained unchanged from resting levels, whereas during exercise, at similar minute ventilation (VE) values EELV was consistently decreased. At the same VE, treadmill running caused an increase in tonic gastric pressure and greater reductions in EELV than either walking or cycling. We conclude that both the exercise stimulus and the resultant hyperpnea stimulate active expiration and a reduced FRC. This new EELV is preserved in the face of moderate changes in mechanical time constants of the lung. This reduced EELV during exercise aids inspiration by optimizing diaphragmatic length and permitting elastic recoil of the chest wall.
我们测定了13名健康受试者在稳态运动期间运动对主动呼气和呼气末肺容积(EELV)的影响。我们还探讨了运动期间影响主动呼气的因素。通过氦稀释技术测定运动对EELV的影响,并通过呼气末食管压力的变化进行验证。我们还使用腹部压力-容积环来测定主动呼气。EELV随着运动强度的增加而降低。即使在轻度稳态运动期间EELV也显著降低,在剧烈运动期间平均降低0.71±0.3升。动态肺顺应性降低30%-50%;EELV仍大于闭合容积。在稳态运动期间改变气流阻力(通过六氟化硫-氧气或氦-氧气呼吸)会改变呼气期间胃和食管压力的峰值,但不会改变EELV;在运动期间通过咬嘴呼吸会产生类似的效果。仰卧位时EELV显著降低。仰卧位运动时不会引发主动呼气,EELV与仰卧位休息时相同。在二氧化碳驱动的通气过度(7-70升/分钟)时,EELV与静息水平保持不变,而在运动期间,在相似的分钟通气量(VE)值时EELV持续降低。在相同的VE下,跑步机跑步导致张力性胃压力增加,并且与步行或骑自行车相比,EELV降低幅度更大。我们得出结论,运动刺激和由此产生的通气过度均会刺激主动呼气并降低功能残气量。面对肺机械时间常数的适度变化,这种新的EELV得以保留。运动期间这种降低的EELV通过优化膈肌长度并允许胸壁弹性回缩来辅助吸气。