McFadden E R, Newton-Howes J
J Clin Invest. 1970 Apr;49(4):779-90. doi: 10.1172/JCI106291.
We investigated the effects of isoproterenol on the pulmonary mechanics of eight healthy male subjects. We measured the flow-volume, pressure-volume, resistance-volume, and pressure-flow relationships of the lungs of our subjects in addition to the forced expiratory volume (FEV(1)). The results of this study confirm earlier observations that isoproterenol produces a considerable decrease in airway resistance but only small changes in maximum expiratory flow. Measurements of static pressure-volume curves showed that isoproterenol caused a temporary decrease in the elastic recoil pressure of the lungs. In five men there were mean falls in recoil pressure of 4.1 cm H(2)O at 85% total lung capacity (TLC), 2.6 cm H(2)O at 75% TLC, and 1.5 cm H(2)O at 50% TLC. We postulate that the reason for the relatively small increments in maximum expiratory flow after isoproterenol is primarily that the effects of airway dilatation are in large part negated by the reduction in lung recoil pressure, which results in a fall in the maximum effective driving force for expiratory air flow, and secondly that there is an increase in the compliance of the flow-limiting airways. These studies emphasize that tests of maximum flow and of airway resistance should not be regarded as invariably interchangeable in the assessment of airway reactions or mild disease of the airways.
我们研究了异丙肾上腺素对8名健康男性受试者肺力学的影响。除了用力呼气量(FEV(1))外,我们还测量了受试者肺部的流量-容积、压力-容积、阻力-容积和压力-流量关系。本研究结果证实了早期的观察结果,即异丙肾上腺素可使气道阻力显著降低,但最大呼气流量仅有微小变化。静态压力-容积曲线测量显示,异丙肾上腺素导致肺弹性回缩压暂时降低。在5名男性中,在肺总量(TLC)的85%时,回缩压平均下降4.1 cm H(2)O,在TLC的75%时下降2.6 cm H(2)O,在TLC的50%时下降1.5 cm H(2)O。我们推测,异丙肾上腺素后最大呼气流量增加相对较小的原因主要是,气道扩张的作用在很大程度上被肺回缩压的降低所抵消,这导致呼气气流的最大有效驱动力下降,其次是限流气道的顺应性增加。这些研究强调,在评估气道反应或轻度气道疾病时,最大流量测试和气道阻力测试不应被视为总是可以相互替代的。