Gerhardt T, Hehre D, Feller R, Reifenberg L, Bancalari E
Department of Pediatrics, University of Miami School of Medicine, FL 33101.
Pediatr Pulmonol. 1987 Sep-Oct;3(5):309-16. doi: 10.1002/ppul.1950030506.
To characterize lung function in young children we measured lung compliance and pulmonary conductance in 40 normal infants and children ranging in age from the newborn period to 5 years. Inspiratory and expiratory flow was measured by a pneumotachograph, esophageal pressure through a water-filled feeding tube, and functional residual capacity (FRC) by a N2 washout technique. The esophageal pressure change per breath [(mean +/- SD) 7.3 +/- 1.4 cm H2O] and specific compliance (75 +/- 13 ml/cm H2O/L-FRC) did not change with growth. Specific conductance was high (0.60 L/s/cm H2O/L-FRC) in preterm infants, decreasing rapidly with initial growth but minimally beyond 10 kg of body weight, and stabilizing at 0.10 L/s/cm H2O/L-FRC. During the age period studied, compliance increased approximately x 25 whereas conductance only rose five-fold. The changes in compliance and conductance were well correlated to FRC, body weight, and length. These findings suggest that in the last trimester of pregnancy the airways are already well developed and postnatal lung growth occurs mainly by formation of new alveoli, leading to a proportional increase in FRC and lung compliance. Postnatally, conductance increases much more slowly than FRC, resulting in a rapid drop in specific conductance.
为了描述幼儿的肺功能,我们测量了40名年龄从新生儿期到5岁的正常婴儿和儿童的肺顺应性和肺传导率。吸气和呼气流量通过呼吸流速计测量,食管压力通过充满水的喂食管测量,功能残气量(FRC)通过氮洗脱技术测量。每次呼吸时食管压力的变化[(平均值±标准差)7.3±1.4 cmH₂O]和比顺应性(75±13 ml/cmH₂O/L-FRC)不随生长而变化。早产儿的比传导率较高(0.60 L/s/cmH₂O/L-FRC),在最初生长阶段迅速下降,但体重超过10 kg后下降极小,并稳定在0.10 L/s/cmH₂O/L-FRC。在所研究的年龄阶段,顺应性增加了约25倍,而传导率仅增加了5倍。顺应性和传导率的变化与FRC、体重和身长密切相关。这些发现表明,在妊娠晚期气道已经发育良好,出生后肺的生长主要通过新肺泡的形成,导致FRC和肺顺应性成比例增加。出生后,传导率的增加比FRC慢得多,导致比传导率迅速下降。