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高通气对胸骨旁肋间肌的不良影响。

Adverse effect of hyperinflation on parasternal intercostals.

作者信息

Ninane V, Gorini M

机构信息

Respiratory Research Unit, Erasme University Hospital, Brussels School of Medicine, Belgium.

出版信息

J Appl Physiol (1985). 1994 Nov;77(5):2201-6. doi: 10.1152/jappl.1994.77.5.2201.

DOI:10.1152/jappl.1994.77.5.2201
PMID:7868434
Abstract

The force-generating ability of the parasternal intercostals is maintained during acute hyperinflation in the dog (Jiang et al. Am. Rev. Respir. Dis. 139: 522-528, 1989). In the present studies, we assessed whether the ability of these muscles to expand the rib cage and inflate the lungs is really maintained. We thus measured the electromyogram and the changes in length of these muscles, the axial motion of the sternum and the ribs, and the changes in pleural pressure and tidal volume in anesthetized vagotomized phrenicotomized dogs during selective parasternal stimulation and during spontaneous breathing at different lung volumes corresponding to 0, 5, 10, and 15 cmH2O positive airway pressure. Compared with functional residual capacity, parasternal stimulation at 15 cmH2O positive airway pressure caused a mild decrease in muscle shortening, a large reduction in cranial rib motion, and a large reduction in pleural pressure fall. The caudal displacement of the sternum, however, was increased. Similar alterations in rib and sternal motions and in muscle shortening were seen during spontaneous breathing; tidal volume was markedly reduced as well. These observations thus indicate that hyperinflation affects the action of the parasternal intercostals on the rib cage; their rib-elevating action is decreased, whereas their action on the sternum is increased. As a result, their ability to inflate the lung is reduced. Thus, the inflationary actions of both the diaphragm and parasternal intercostals are reduced by hyperinflation.

摘要

犬急性肺过度充气时,胸骨旁肋间肌的力量产生能力得以维持(Jiang等人,《美国呼吸与危重症医学杂志》139: 522 - 528, 1989)。在本研究中,我们评估了这些肌肉扩张胸廓和使肺充气的能力是否真的得以维持。因此,我们在选择性刺激胸骨旁肌以及在不同肺容量(对应气道正压为0、5、10和15 cmH₂O)下自主呼吸时,测量了麻醉、切断迷走神经和膈神经的犬的这些肌肉的肌电图、长度变化、胸骨和肋骨的轴向运动以及胸膜压力和潮气量的变化。与功能残气量相比,气道正压为15 cmH₂O时刺激胸骨旁肌导致肌肉缩短轻度减少、肋骨向上运动大幅减少以及胸膜压力下降大幅减少。然而,胸骨的尾端移位增加。在自主呼吸时也观察到肋骨和胸骨运动以及肌肉缩短有类似变化;潮气量也显著减少。这些观察结果表明,肺过度充气会影响胸骨旁肋间肌对胸廓的作用;它们提升肋骨(向上运动)的作用减弱,而它们对胸骨的作用增强。结果,它们使肺充气的能力降低。因此,膈肌和胸骨旁肋间肌的充气作用都会因肺过度充气而减弱。

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