Munakata M, Homma Y, Matsuzaki M, Ogasawara H, Tanimura K, Kusaka H, Kawakami Y
J Appl Physiol (1985). 1986 Sep;61(3):1120-5. doi: 10.1152/jappl.1986.61.3.1120.
Lung crackles may be produced by the opening of small airways or by the sudden expansion of alveoli. We studied the generation of crackles in excised canine lobes ventilated in an airtight box. Total airflow, transairway pressure (Pta), transpulmonary pressure (Ptp), and crackles were recorded simultaneously. Crackles were produced only during inflation and had high-peak frequencies (738 +/- 194 Hz, mean +/- SD). During inflation, crackles were produced from 111 +/- 83 ms (mean +/- SD) prior to the negative peak of Pta, presumably when small airways began to open. When end-expiratory Ptp was set constant between 15 and 20 cmH2O and end-expiratory Ptp was gradually reduced from 5 cmH2O to -15 or -20 cmH2O in a breath-by-breath manner, crackles were produced in the cycles in which end-expiratory Ptp fell below -1 to 1 cmH2O. This pressure was consistent with previously known airway closing pressures. When end-expiratory Ptp was set constant at -10 cmH2O and end inspiratory Ptp was gradually increased from -5 to 15 or 20 cmH2O, crackles were produced in inspiratory phase in which end-inspiratory Ptp exceeded 4-6 cmH2O. This pressure was consistent with previously known airway opening pressures. These results indicate that crackles in excised normal dog lungs are produced by opening of peripheral airways and are not generated by the sudden inflation of groups of alveoli.
肺部啰音可能由小气道的开放或肺泡的突然扩张产生。我们研究了在气密箱中通气的离体犬肺叶中啰音的产生情况。同时记录了总气流、气道跨压(Pta)、肺跨压(Ptp)和啰音。啰音仅在吸气时产生,且具有高频峰值(738±194赫兹,平均值±标准差)。在吸气过程中,啰音在Pta负峰之前111±83毫秒(平均值±标准差)时产生,推测此时小气道开始开放。当呼气末Ptp在15至20厘米水柱之间保持恒定时,并且呼气末Ptp以逐次呼吸的方式从5厘米水柱逐渐降至-15或-20厘米水柱时,在呼气末Ptp降至-1至1厘米水柱以下的周期中会产生啰音。该压力与先前已知的气道关闭压力一致。当呼气末Ptp设定为-10厘米水柱恒定,吸气末Ptp从-5逐渐增加至15或20厘米水柱时,在吸气末Ptp超过4至6厘米水柱的吸气相中会产生啰音。该压力与先前已知的气道开放压力一致。这些结果表明,离体正常犬肺中的啰音是由外周气道开放产生的,而非由肺泡群的突然充气产生。