Gottfried S B, Redline S, Altose M D
Am Rev Respir Dis. 1985 Nov;132(5):954-9. doi: 10.1164/arrd.1985.132.5.954.
Previous work has demonstrated that the perception of added resistive loads is blunted in patients with chronic obstructive pulmonary disease (COPD). It is not clear, however, whether this is due to reduced levels of respiratory muscle force during loaded breathing or to a specific abnormality in respiratory sensation. In the present study, the psychophysical technique of magnitude scaling was used to evaluate the sensation of external resistive and elastic ventilatory loads as well as the perception of inspired volume and inspiratory muscle force in 14 patients with COPD and in 12 normal subjects of similar age. The exponents of the power function relationships between load magnitude and sensation intensity for both resistive and elastic loads were significantly reduced in the patients with COPD compared with those in the normal subjects. While breathing against any given ventilatory load, the peak inspiratory mouth pressure and inspiratory duration were comparable in the 2 groups. Thus, the exponents of the power function relationships between peak inspiratory mouth pressure and sensation intensity were significantly lower in the patients with COPD (0.92 +/- SE 0.17 and 0.96 +/- SE 0.17 for resistive and elastic loads, respectively) compared with those obtained in the normal subjects (1.47 +/- SE 0.12 for resistive loads and 1.52 +/- SE 0.17 for elastic loads) (p less than 0.05). In contrast, the perception of inspired volume and of respiratory muscle force during static inspiratory maneuvers as determined by magnitude estimation and production were no different in either group.(ABSTRACT TRUNCATED AT 250 WORDS)
先前的研究表明,慢性阻塞性肺疾病(COPD)患者对增加的阻力负荷的感知会减弱。然而,尚不清楚这是由于负荷呼吸期间呼吸肌力量水平降低,还是由于呼吸感觉的特定异常所致。在本研究中,采用量级缩放的心理物理学技术,评估了14例COPD患者和12例年龄相仿的正常受试者对外部阻力和弹性通气负荷的感觉,以及对吸入气量和吸气肌力量的感知。与正常受试者相比,COPD患者中阻力负荷和弹性负荷的负荷大小与感觉强度之间的幂函数关系指数显著降低。在对抗任何给定的通气负荷呼吸时,两组的吸气口峰值压力和吸气持续时间相当。因此,与正常受试者相比,COPD患者中吸气口峰值压力与感觉强度之间的幂函数关系指数显著更低(阻力负荷和弹性负荷分别为0.92±标准误0.17和0.96±标准误0.17)(正常受试者阻力负荷为1.47±标准误0.12,弹性负荷为1.52±标准误0.17)(p<0.05)。相比之下,通过量级估计和产生来确定的静态吸气动作期间对吸入气量和呼吸肌力量的感知在两组中并无差异。(摘要截短于250字)