Scano G, Lo Conte C, Spinelli A, Duranti R, Gigliotti F, Turco R, Stendardi L, Emmi L, Arcangeli P
Int J Clin Pharmacol Ther Toxicol. 1986 Sep;24(9):490-5.
Both vagal and non-vagal afferences from the lung or chest wall contribute to increasing neural drive to the respiratory muscles, but only the former are known to change the breathing pattern by increasing respiratory frequency (RF) during bronchoconstriction. In order to evaluate the relative contribution of vagal and non-vagal afferences to increasing neural drive to the respiratory muscles in 14 asymptomatic asthmatic patients known to be responsive (decrease in FEV1 greater than 20% of the control values) to previous bronchial provocation test (BPT) with aerosolized histamine, we evaluated FEV1, breathing pattern and neuromuscular drive, as assessed by mouth occlusion pressure (PO.1), under control conditions, during BPT with progressive doubling doses of inhaled histamine (H) and 5 min after inhalation of a bronchodilator agent (Reproterol) (B). During HBPT FEV1 exhibited a significant decrease (p less than 0.01) while PO.1 was found to increase significantly (p less than 0.01). However, no significant changes were noted in breathing pattern. After B FEV1 returned to control values while PO.1, even if significantly reduced (p less than 0.01), did not. Changes in PO.1 were found to be significantly related to changes in FEV1 both during HBPT and B (p less than 0.05). The data suggest that in these patients non-vagal afferences, linked to the abnormalities of thoraco-pulmonary mechanics, could play a major role in changing neural drive to the respiratory muscles.
来自肺部或胸壁的迷走神经和非迷走神经传入信号均有助于增加对呼吸肌的神经驱动，但已知只有前者在支气管收缩时通过增加呼吸频率（RF）来改变呼吸模式。为了评估迷走神经和非迷走神经传入信号对14名已知对先前雾化组胺支气管激发试验（BPT）有反应（第一秒用力呼气容积（FEV1）下降大于对照值的20%）的无症状哮喘患者增加呼吸肌神经驱动的相对贡献，我们在对照条件下、吸入组胺（H）剂量递增加倍的BPT期间以及吸入支气管扩张剂（瑞普特罗）（B）5分钟后，评估了FEV1、呼吸模式和神经肌肉驱动（通过口腔阻断压（PO.1）评估）。在组胺激发支气管激发试验（HBPT）期间，FEV1显著下降（p<0.01），而PO.1显著增加（p<0.01）。然而，呼吸模式未发现显著变化。在B之后，FEV1恢复到对照值，而PO.1即使显著降低（p<0.01）也未恢复。发现在HBPT和B期间，PO.1的变化与FEV1的变化显著相关（p<0.05）。数据表明，在这些患者中，与胸肺力学异常相关的非迷走神经传入信号可能在改变呼吸肌的神经驱动中起主要作用。
