Macefield V G, Wallin B G
Department of Clinical Neuroscience, Sahlgren's Hospital, University of Göteborg, Sweden.
J Auton Nerv Syst. 1995 Jun 25;53(2-3):148-56. doi: 10.1016/0165-1838(94)00174-i.
Muscle sympathetic activity is inhibited during the second half of phasic lung inflation associated with normal (negative pressure) breathing or artificial ventilation with intermittent positive-pressure, and this inspiratory inhibition appears unrelated to the associated changes in arterial pressure. In this present study we tested the hypothesis that a static inflation of the lungs would cause a sustained inhibition of muscle sympathetic activity. Microneurographic techniques were used to record muscle sympathetic activity from the peroneal nerve, and arterial pressure was monitored continuously by finger-pulse photoplethysmography (Finapres). In nine subjects static lung inflation, brought about either actively or passively, caused a pronounced and sustained increase in sympathetic activity (not the predicted decrease) that could not be explained by changes in arterial pressure. When delivered at the end of a voluntary end-expiratory apnoea, static lung inflation caused an initial inhibition of the large chemoreceptor-induced sympathetic bursts and a subsequent excitation that was sustained for the duration of the lung inflation. These observations indicate that respiration can affect muscle sympathetic activity in humans in two opposing ways: inhibition during phasic increases in lung volume, and excitation during large static increases in lung volume. Neither phenomenon depends on changes in arterial pressure, and hence influences of carotid arterial and aortic (high-pressure) baroreceptors can be excluded. We suggest that the initial inhibition is evoked from lung or chest-wall receptors and the static exitation from unloading of cardiopulmonary (low pressure) baroreceptors.
在与正常(负压)呼吸或间歇性正压人工通气相关的阶段性肺充气的后半段,肌肉交感神经活动受到抑制,并且这种吸气抑制似乎与动脉压的相关变化无关。在本研究中,我们检验了这样一个假设,即肺的静态充气会导致肌肉交感神经活动的持续抑制。采用微神经图技术记录腓总神经的肌肉交感神经活动,并用手指脉搏光电容积描记法(Finapres)持续监测动脉压。在9名受试者中,主动或被动引起的肺静态充气导致交感神经活动显著且持续增加(而非预期的降低),这无法用动脉压的变化来解释。当在自主呼气末暂停结束时进行肺静态充气时,会引起对大化学感受器诱发的交感神经爆发的初始抑制以及随后的兴奋,这种兴奋在肺充气期间持续存在。这些观察结果表明,呼吸可以通过两种相反的方式影响人体的肌肉交感神经活动:在肺容积阶段性增加时产生抑制,在肺容积大幅静态增加时产生兴奋。这两种现象均不依赖于动脉压的变化,因此可以排除颈动脉和主动脉(高压)压力感受器的影响。我们认为,初始抑制是由肺或胸壁感受器诱发的,而静态兴奋是由心肺(低压)压力感受器卸载引起的。