Grassino A, Macklem P T
Annu Rev Med. 1984;35:625-47. doi: 10.1146/annurev.me.35.020184.003205.
In this review emphasis is placed on some major mechanisms involved in inspiratory muscle fatigue. It is certain that respiratory muscle fatigue is a clinical entity, with broad implication in internal medicine. As yet its prevalence is largely unknown. There is reasonable certainty of some of the mechanisms leading to fatigue, for example the effect of loads and circulation. However, the cellular mechanisms, both chemical and electrophysiological, remain obscure. In detecting respiratory muscle fatigue various tests already represent windows from which we can see the malfunction of some mechanisms, unfortunately often not understood. The ideal test to evaluate respiratory muscle fatigue (easy to perform, sensitive, specific, and reliable) has not been developed yet. The clinical identification of respiratory muscle fatigue is still developing, and only tentative guidelines for its treatment can be proposed at this stage. Clearly, much research is required to determine prevalence, establish the diagnosis, and evaluate therapy.
本综述重点关注吸气肌疲劳涉及的一些主要机制。呼吸肌疲劳无疑是一种临床病症，在内科领域具有广泛影响。目前其患病率很大程度上尚不清楚。对于某些导致疲劳的机制，例如负荷和循环的影响，已有一定的确定性认识。然而，细胞层面的化学和电生理机制仍不明确。在检测呼吸肌疲劳时，各种测试已成为我们了解某些机制功能失调的窗口，但不幸的是，这些机制往往不为人所理解。评估呼吸肌疲劳的理想测试（易于操作、敏感、特异且可靠）尚未研发出来。呼吸肌疲劳的临床识别仍在发展中，现阶段只能提出初步的治疗指南。显然，需要开展大量研究来确定患病率、建立诊断方法并评估治疗效果。
