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肺容积对正常人类最大乙酰甲胆碱诱导支气管收缩的影响。

Effects of lung volume on maximal methacholine-induced bronchoconstriction in normal humans.

作者信息

Ding D J, Martin J G, Macklem P T

出版信息

J Appl Physiol (1985). 1987 Mar;62(3):1324-30. doi: 10.1152/jappl.1987.62.3.1324.

Abstract

We examined the effects of lung volume on the bronchoconstriction induced by inhaled aerosolized methacholine (MCh) in seven normal subjects. We constructed dose-response curves to MCh, using measurements of inspiratory pulmonary resistance (RL) during tidal breathing at functional residual capacity (FRC) and after a change in end-expiratory lung volume (EEV) to either FRC -0.5 liter (n = 5) or FRC +0.5 liter (n = 2). Aerosols of MCh were generated using a nebulizer with an output of 0.12 ml/min and administered for 2 min in progressively doubling concentrations from 1 to 256 mg/ml. After MCh, RL rose from a base-line value of 2.1 +/- 0.3 cmH2O. 1-1 X s (mean +/- SE; n = 7) to a maximum of 13.9 +/- 1.8. In five of the seven subjects a plateau response to MCh was obtained at FRC. There was no correlation between the concentration of MCh required to double RL and the maximum value of RL. The dose-response relationship to MCh was markedly altered by changing lung volume. The bronchoconstrictor response was enhanced at FRC - 0.5 liter; RL reached a maximum of 39.0 +/- 4.0 cmH2O X 1-1 X s. Conversely, at FRC + 0.5 liter the maximum value of RL was reduced in both subjects from 8.2 and 16.6 to 6.0 and 7.7 cmH2O X 1-1 X s, respectively. We conclude that lung volume is a major determinant of the bronchoconstrictor response to MCh in normal subjects. We suggest that changes in lung volume act to alter the forces of interdependence between airways and parenchyma that oppose airway smooth muscle contraction.

摘要

我们研究了肺容积对7名正常受试者吸入雾化乙酰甲胆碱(MCh)所致支气管收缩的影响。我们构建了对MCh的剂量反应曲线,采用在功能残气量(FRC)时潮气呼吸期间以及呼气末肺容积(EEV)改变至FRC - 0.5升(n = 5)或FRC + 0.5升(n = 2)后测量吸气肺阻力(RL)的方法。使用输出量为0.12 ml/min的雾化器产生MCh气雾剂,以1至256 mg/ml逐渐加倍的浓度给药2分钟。给予MCh后,RL从基线值2.1±0.3 cmH₂O·1⁻¹·s(平均值±标准误;n = 7)升至最大值13.9±1.8。在7名受试者中的5名,于FRC时获得了对MCh的平台反应。使RL加倍所需的MCh浓度与RL的最大值之间无相关性。改变肺容积显著改变了对MCh的剂量反应关系。在FRC - 0.5升时支气管收缩反应增强;RL达到最大值39.0±4.0 cmH₂O·1⁻¹·s。相反,在FRC + 0.5升时,两名受试者的RL最大值分别从8.2和16.6降至6.0和7.7 cmH₂O·1⁻¹·s。我们得出结论,肺容积是正常受试者对MCh支气管收缩反应的主要决定因素。我们认为肺容积的改变起到改变气道与实质之间相互依存力的作用,这些力对抗气道平滑肌收缩。

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