Brennan N J, Morris A J, Green M
Thorax. 1983 Jan;38(1):62-6. doi: 10.1136/thx.38.1.62.
Thoracoabdominal motion and intrathoracic (oesophageal), intra-abdominal (gastric), and transdiaphragmatic pressures were measured during tidal breathing in 20 erect subjects--six normal, seven, with emphysema, and seven with fibrosing alveolitis. In normal subjects all diameters increased synchronously during inspiration and were accompanied by rises in abdominal and transdiaphragmatic pressures. Five patients with fibrosing alveolitis showed a reduction in upper ribcage motion, but normal lower ribcage and abdominal motion; stiff fibrotic lungs may sometimes impair the ability of the diaphragm to expand the upper ribcage and result in proportionally more expansion of the bases. Four emphysematous patients showed increased anteroposterior motion of the ribcage and four showed paradoxical inward motion of the lower ribcage during inspiration. These changes apparently result from increased activity of intercostal and accessory muscles and altered configuration of the diaphragm. The muscles of patients with large, overinflated lungs are at a greater disadvantage than those with small fibrosed lungs.
在20名直立受试者进行潮气呼吸期间，测量了胸腹部运动以及胸腔内（食管）、腹腔内（胃）和跨膈肌压力。这20名受试者中，6名正常，7名患有肺气肿，7名患有肺纤维化。在正常受试者中，吸气时所有直径同步增加，并伴有腹部和跨膈肌压力升高。5名肺纤维化患者上胸廓运动减少，但下胸廓和腹部运动正常；僵硬的纤维化肺有时可能会损害膈肌扩张上胸廓的能力，导致肺底部扩张比例更大。4名肺气肿患者胸廓前后运动增加，4名患者在吸气时下胸廓出现反常向内运动。这些变化显然是由肋间肌和辅助肌活动增加以及膈肌形态改变引起的。肺过度膨胀的患者的肌肉比肺纤维化较小的患者的肌肉处于更大的劣势。
