Macklem P T, Roussos C, Derenne J P, Delhez L
Respir Physiol. 1979 Oct;38(2):141-52. doi: 10.1016/0034-5687(79)90033-1.
During Mueller maneuvers (MM), the volume change of rib cage, delta Vrc, and abdomen, delta Vab, are equal and opposite. Thus delta Vrc = -delta Vab. Substituting delta Prc.Crc for delta Vrc and delta Pab.Cab for delta Vab yields: delta Prc = - delta Pab.Cab/Crc, where delta Prc, delta Pab, Crc and Cab are applied pressures and compliances of rib cage and abdomen respectively. MM performed solely with the diaphragm permits calculations of Prc in terms of observed changes in Pab and pleural pressure, Ppl. Three trained subjects performed MM with no evidence of inspiratory intercostal or abdominal muscle contraction. During the diaphragmatic MM delta Pab was positive and delta Prc negative. The magnitude of delta Prc/delta Pab was 2-6 times greater than that of delta Ppl/delta Pab. We conclude that neither Pab nor Ppl by themselves displace the relaxed rib cage during Mueller maneuvers. A model in which the diaphragm acts both in parallel and in series with the rib cage, and in which Prc is the sum of Pab and a pressure lying between Pab and Ppl explains these results as well as the hypothesis that Pab displaces the relaxed rib cage during quiet breathing.
在米勒动作(MM)过程中,胸廓的容积变化(ΔVrc)和腹部的容积变化(ΔVab)大小相等、方向相反。因此,ΔVrc = -ΔVab。用ΔPrc·Crc代替ΔVrc,用ΔPab·Cab代替ΔVab,可得:ΔPrc = -ΔPab·Cab/Crc,其中ΔPrc、ΔPab、Crc和Cab分别是胸廓和腹部的作用压力及顺应性。仅通过膈肌进行MM时,可根据观察到的ΔPab和胸膜压力(Ppl)的变化来计算Prc。三名经过训练的受试者进行MM时,未出现吸气性肋间肌或腹肌收缩的迹象。在膈肌MM过程中,ΔPab为正,ΔPrc为负。ΔPrc/ΔPab的大小比ΔPpl/ΔPab大2至6倍。我们得出结论,在米勒动作过程中,单独的ΔPab或Ppl都不会使松弛的胸廓移位。一个膈肌与胸廓既并联又串联起作用,且Prc是ΔPab与介于ΔPab和Ppl之间的一个压力之和的模型,既能解释这些结果,也能解释关于在安静呼吸时ΔPab使松弛的胸廓移位的假说。