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单次呼吸氮洗脱;肺容积和弹性回缩改变的影响。

Single-breath nitrogen washout; effects of alterations of lung volumes and elastic recoil.

作者信息

Al-Bazzaz F J

出版信息

Chest. 1979 Jul;76(1):83-8. doi: 10.1378/chest.76.1.83.

Abstract

Strapping of the chest causes decreased lung volumes and increased elastic recoil pressure. Such strapping was used in conjunction with single-breath nitrogen washout to study the effects of changes in these factors on the dynamics of the small airways. Studies consisted of simultaneous measurements of the quasistatic lung pressure-volume curve and single-breath nitrogen washout. Strapping caused significant reductions in all lung volumes and in lung compliance at 50 percent of the total lung capacity (TLC). The volume of phase 4 was not changed; however, the ratio of closing capacity to control TLC decreased from 29.9 +/- 6 percent to 24.2 +/- 4 percent with strapping (P less than 0.02). This observation indicates that the onset of closing volumes occurred at a lower absolute lung volume during strapping, compared with control. The closing pressure of 2.1 +/- 0.8 cm H2O was not altered by strapping of the chest. The slope of phase 3 of the single-breath nitrogen-washout test and the average alveolar concentration of nitrogen were increased during strapping. A similar phenomenon occurred in three subjects who performed the single-breath nitrogen-washout test following partial vital capacities. A reduction of the onset of closure of the airways without a change in closing pressure suggests that restrictions of the chest wall caused no change in mechanical properties of the small airways. Elevation of the slope of the alveolar plateau is probably due to exaggeration of the apex-to-base nitrogen difference consequent to the strapping-associated decreased lung and alveolar compliance.

摘要

胸部束缚会导致肺容积减小和弹性回缩压力增加。这种束缚与单次呼吸氮洗脱相结合,用于研究这些因素变化对小气道动力学的影响。研究包括同时测量准静态肺压力-容积曲线和单次呼吸氮洗脱。束缚导致所有肺容积以及在肺总量(TLC)的50%时的肺顺应性显著降低。第4期的容积未改变;然而,与束缚前相比,闭合容量与对照TLC的比值从29.9±6%降至24.2±4%(P<0.02)。这一观察结果表明,与对照相比,在束缚期间,闭合容积的起始发生在更低的绝对肺容积时。胸部束缚未改变2.1±0.8 cmH₂O的闭合压力。束缚期间,单次呼吸氮洗脱试验第3期的斜率和氮的平均肺泡浓度增加。在进行部分肺活量后进行单次呼吸氮洗脱试验的三名受试者中也出现了类似现象。气道闭合起始的降低而闭合压力无变化表明胸壁受限未导致小气道力学特性改变。肺泡平台斜率的升高可能是由于束缚相关的肺和肺泡顺应性降低导致肺尖到肺底氮差异夸大所致。

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