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吞咽引起的人体呼吸相位重置和气流变化。

Respiratory phase resetting and airflow changes induced by swallowing in humans.

作者信息

Paydarfar D, Gilbert R J, Poppel C S, Nassab P F

机构信息

Department of Medicine, St Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA 02135, USA.

出版信息

J Physiol. 1995 Feb 15;483 ( Pt 1)(Pt 1):273-88. doi: 10.1113/jphysiol.1995.sp020584.

DOI:10.1113/jphysiol.1995.sp020584
PMID:7776238
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1157888/
Abstract
  1. Relationships between the timing of respiration and deglutition were studied in thirty awake healthy subjects at rest. Deglutition was monitored by submental electromyography, pharyngeal manometry and videofluoroscopy. Respiration was recorded by measurement of oronasal airflow and chest wall movement. Three types of deglutition were studied: injected bolus swallows, spontaneous swallows, and visually cued swallows of boluses previously placed in the mouth. 2. The effect of each swallow on respiratory rhythm was characterized by measurement of cophase, defined as the interval between the onset of deglutitive submental EMG activity to the onset of subsequent rescheduled inspirations. Cophase was determined for swallows initiated at different phases of the respiratory cycle. In all subjects deglutition caused phase resetting of respiratory rhythm. Cophase was largest for swallows initiated near the the inspiratory-expiratory (E-I) transition and smallest for swallows initiated near the expiratory-inspiratory (E-I) transition. The pattern of respiratory resetting by deglutition was topologically classified as type 0. This pattern was shown for swallows induced by bolus injection or visual cue, and for spontaneous swallows. 3. The incidence of spontaneous deglutition was influenced by the position of the swallow in the respiratory cycle. Few spontaneous swallows were initiated near the E-I transition whereas most occurred from late inspiration to mid-expiration. 4. Deglutition caused an abrupt decrease in airflow leading to an interval of apnoea, followed by a period of expiration. The duration of deglutition apnoea for spontaneous swallows was shorter than that for 5 ml bolus swallows, and was unaffected by the respiratory phase of swallow initiation. The period of expiration after swallowing was longest for swallows initiated at the I-E transition, and shortest for E-I swallows. 5. The intervals between bolus injection and the onset of deglutition apnoea, and the timing of swallowing events, were not significantly altered by the phase in the respiratory cycle at which swallowing was exhibited. 6. To quantify the relationship between bolus flow and respiration, we determined the latencies between cessation of inspiratory airflow and arrival of the bolus at the larynx (alpha), and between laryngeal bolus departure and resumption of inspiratory airflow (delta). Both values were dependent upon the respiratory phase of swallowing. The lowest values for alpha and delta were found for early-inspiratory and late-expiratory swallows, respectively. 7. We conclude that swallowing causes respiratory phase resetting with a pattern that is characteristic of the strong perturbations of an attractor-cycle oscillator.(ABSTRACT TRUNCATED AT 400 WORDS)
摘要
  1. 对30名清醒的静息健康受试者呼吸与吞咽的时间关系进行了研究。通过颏下肌电图、咽测压法和电视荧光透视法监测吞咽情况。通过测量口鼻气流和胸壁运动记录呼吸情况。研究了三种吞咽类型:注入团块吞咽、自发吞咽以及对先前置于口腔中的团块进行视觉提示吞咽。2. 通过测量共相来表征每次吞咽对呼吸节律的影响,共相定义为吞咽颏下肌电图活动开始至随后重新安排的吸气开始之间的间隔。确定了在呼吸周期不同阶段开始的吞咽的共相。在所有受试者中,吞咽均导致呼吸节律的相位重置。在吸气-呼气(E-I)转换附近开始的吞咽共相最大,在呼气-吸气(E-I)转换附近开始的吞咽共相最小。吞咽引起的呼吸重置模式在拓扑学上分类为0型。这种模式在团块注射或视觉提示诱导的吞咽以及自发吞咽中均有体现。3. 自发吞咽的发生率受吞咽在呼吸周期中位置的影响。在E-I转换附近很少有自发吞咽开始,而大多数自发吞咽发生在吸气后期至呼气中期。4. 吞咽导致气流突然减少,引发一段呼吸暂停期,随后是一段呼气期。自发吞咽的吞咽呼吸暂停持续时间短于5毫升团块吞咽,且不受吞咽开始时呼吸相位的影响。吞咽后呼气期在I-E转换处开始的吞咽最长,在E-I吞咽时最短。5. 团块注射与吞咽呼吸暂停开始之间的间隔以及吞咽事件的时间,在吞咽出现时的呼吸周期阶段中没有显著改变。6. 为了量化团块流动与呼吸之间的关系,我们确定了吸气气流停止与团块到达喉部之间的延迟(α),以及喉部团块离开与吸气气流恢复之间的延迟(δ)。这两个值均取决于吞咽的呼吸相位。α和δ的最低值分别在吸气早期和呼气后期的吞咽中发现。7. 我们得出结论,吞咽导致呼吸相位重置,其模式具有吸引子周期振荡器强烈扰动的特征。(摘要截断于400字)
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb0/1157888/972f870e6413/jphysiol00325-0273-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb0/1157888/972f870e6413/jphysiol00325-0273-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb0/1157888/972f870e6413/jphysiol00325-0273-a.jpg

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The protection of the laryngeal airway during swallowing.吞咽过程中喉气道的保护。
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NEUROPHYSIOLOGIC OBSERVATIONS OF NORMAL DEGLUTITION. I. ITS RELATIONSHIP TO THE RESPIRATORY CYCLE.正常吞咽的神经生理学观察。I. 其与呼吸周期的关系。
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Breathing-Swallowing discoordination after definitive chemoradiotherapy for head and neck cancers is associated with aspiration pneumonia.头颈部癌症根治性放化疗后呼吸-吞咽不协调与吸入性肺炎有关。
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