Ward M E, Stubbing D G
Am Rev Respir Dis. 1985 Sep;132(3):652-6. doi: 10.1164/arrd.1985.132.3.652.
The perceived magnitude of externally added loads to breathing was estimated in 10 normal subjects and 10 patients with chronic lung disease (5 obstructive, 5 interstitial disorders) to determine if chronic mechanical abnormalities of the respiratory system are accompanied by changes in the perception of dyspnea. Flow rates and tidal volumes were varied to assess the effect of altered patterns of breathing. With added resistive loads, the perceived magnitude increased as both resistance and the flow rate increased. With elastic loads the perceived magnitude increased as both elastance and tidal volume increased. In all subjects, perceived magnitude of added loads was most directly related to the inspiratory pressure used to overcome the load. Although the exponent for the power function relationship between perceived magnitude and the physical magnitude of the load was affected by the subject's age, there was no difference between the patients studied and the age-matched normal subjects. The results indicate that the sensation associated with added loads to breathing is the same in patients with chronic lung disease as in normal subjects. Also, they suggest that the altered pattern of breathing in patients with chronic lung disease is a behavioral adaptation to minimize respiratory distress.
对10名正常受试者和10名慢性肺病患者(5名阻塞性疾病患者、5名间质性疾病患者)进行了外部施加于呼吸的负荷感知强度评估,以确定呼吸系统的慢性机械异常是否伴有呼吸困难感知的变化。改变流速和潮气量以评估呼吸模式改变的影响。施加阻力负荷时,随着阻力和流速增加,感知强度增大。施加弹性负荷时,随着弹性和潮气量增加,感知强度增大。在所有受试者中,施加负荷的感知强度与用于克服负荷的吸气压力最直接相关。尽管感知强度与负荷物理强度之间幂函数关系的指数受受试者年龄影响,但所研究的患者与年龄匹配的正常受试者之间并无差异。结果表明,慢性肺病患者与正常受试者对呼吸附加负荷的感觉相同。此外,结果还表明,慢性肺病患者呼吸模式的改变是一种行为适应,以尽量减少呼吸窘迫。