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吸气流量对正常人和哮喘患者支气管运动张力的影响。

Effect of inspiratory flow rate on bronchomotor tone in normal and asthmatic subjects.

作者信息

Hida W, Arai M, Shindoh C, Liu Y N, Sasaki H, Takishima T

出版信息

Thorax. 1984 Feb;39(2):86-92. doi: 10.1136/thx.39.2.86.

Abstract

The effect of the inspiratory flow rate during deep inspiration on the regulation of bronchomotor tone was studied in nine normal and 22 asthmatic subjects. Changes in bronchial tone were assessed by respiratory resistance measured by an oscillation method. In normal subjects with bronchoconstriction induced by methacholine a rapid deep inspiration reduced respiratory resistance more than a slow deep inspiration. Asthmatic subjects with spontaneous airway narrowing showed an increase in respiratory resistance after deep inspiration that was greater after rapid than after slow deep inspiration. On the other hand, in asthmatics with methacholine induced bronchoconstriction, bronchodilatation occurred after deep inspiration and this was also greater after rapid than after slow deep inspiration. Lignocaine inhalation attenuated both bronchoconstriction and bronchodilatation induced by both slow and rapid deep inspiration. These results suggest that the effects of deep inspiration are mediated at least in part via receptors in the airways. It is suggested that in asthmatic patients with spontaneous bronchoconstriction irritant receptor activity will be increased in proportion to the speed of inspiration. After methacholine induced bronchoconstriction stretch receptor activity is likely to behave in a similar fashion, leading to an opposite effect.

摘要

在9名正常受试者和22名哮喘患者中研究了深吸气时吸气流量对支气管运动张力调节的影响。通过振荡法测量呼吸阻力来评估支气管张力的变化。在由乙酰甲胆碱诱发支气管收缩的正常受试者中,快速深吸气比缓慢深吸气能更显著地降低呼吸阻力。有自发性气道狭窄的哮喘患者在深吸气后呼吸阻力增加,且快速深吸气后的增加幅度大于缓慢深吸气后的增加幅度。另一方面,在由乙酰甲胆碱诱发支气管收缩的哮喘患者中,深吸气后会出现支气管扩张,且快速深吸气后的扩张程度也大于缓慢深吸气后的扩张程度。吸入利多卡因可减弱缓慢和快速深吸气所诱发的支气管收缩和支气管扩张。这些结果表明,深吸气的作用至少部分是通过气道中的受体介导的。有人提出,在有自发性支气管收缩的哮喘患者中,刺激感受器的活性将与吸气速度成比例增加。在乙酰甲胆碱诱发支气管收缩后,牵张感受器的活性可能会以类似方式表现,从而导致相反的效果。

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