Mink S N, Unruh H W, Oppenheimer L
J Appl Physiol (1985). 1985 Dec;59(6):1704-15. doi: 10.1152/jappl.1985.59.6.1704.
We examined the changes in vascular and interstitial mechanics in pulmonary emphysema (PE) using a canine lobar model. PE was produced in the left lower lobe (LLL) of five dogs (group E) by six weekly intrabronchial instillations of the enzyme papain. In five control dogs (group C), a normal saline solution was used. In our in vivo preparation, vascular flow (Q) to the LLL was measured. Inflow (Ppa) and outlow (Pv) pressures to the LLL could be varied independently. The relationship of Ppa to Q was examined in zones 2 and 3 of West. The slope of the Ppa-Q relationship was used to determine vascular conductance, whereas the extrapolation to zero flow in zone 2 conditions represented the mean pressure required for vascular recruitment (Pi). Lobar weight gain was measured continuously. Following step increases in Ppa, the rapid increase in wet weight measured when Q to the LLL was zero was used to obtain vascular compliance (C). Subsequent slow increases in wet weight were used to determine the rate of fluid exchange with the interstitium (Qf). The slope of the Qf-Ppa relationship represented fluid conductance (Kf). The extrapolation to zero Qf gave the minimal pressure required for continuous edema formation (Pm). Compared with group C, vascular conductance (G) decreased and Pi increased in group E, whereas fluid conductance (Kf) and Pm increased. The decrease in G most likely resulted from the loss of vascular cross-sectional area in emphysematous lungs, whereas the increase in Pi was possibly due to mechanical changes in the lung interstitium which increased vessel closure. We propose that the increase in Kf in group E reflected an increase in interstitial conductance, such that due to structural changes in the interstitium in emphysematous lungs, tissue resistance to fluid flux decreased.
我们使用犬肺叶模型研究了肺气肿(PE)时血管和间质力学的变化。通过每周6次经支气管内滴注木瓜蛋白酶,在5只犬的左下叶(LLL)制造PE(E组)。5只对照犬(C组)滴注生理盐水。在我们的体内实验中,测量了LLL的血管流量(Q)。LLL的流入压(Ppa)和流出压(Pv)可独立改变。研究了West 2区和3区Ppa与Q的关系。Ppa-Q关系的斜率用于确定血管传导率,而在2区条件下外推至零流量代表血管募集所需的平均压力(Pi)。持续测量肺叶重量增加。在Ppa阶跃增加后,当LLL的Q为零时测量的湿重快速增加用于获得血管顺应性(C)。随后湿重的缓慢增加用于确定与间质的液体交换率(Qf)。Qf-Ppa关系的斜率代表液体传导率(Kf)。外推至零Qf得到持续水肿形成所需的最小压力(Pm)。与C组相比,E组血管传导率(G)降低,Pi升高,而液体传导率(Kf)和Pm升高。G的降低很可能是由于肺气肿肺脏血管横截面积的减少,而Pi的升高可能是由于肺间质的机械变化导致血管闭合增加。我们认为E组Kf的增加反映了间质传导率的增加,即由于肺气肿肺脏间质的结构变化,组织对液体通量的阻力降低。