Marek W, Hoffarth H P, Potthast J, Ulmer W T, Baur X
Berufgenossenschaftliches Forschungsinstitut für Arbeitsmedizin (BGFA), Institut an der Ruhr-Universität Bochum.
Pneumologie. 1994 Jun;48(6):433-42.
Respiratory responses after inhalative challenge tests using methacholine (MCH) are intensively investigated and described in the literature. There is however a considerable lack of knowledge about the correlation of bronchoconstrictory responses to cardiovascular changes like pulmonary arterial pressure or blood gas tensions after unspecific challenges with methacholine or with specific allergens. Ten yearling sheep inhaled MCH-aerosols in increasing concentrations of 0.5, 1.0, 2.0, 5.0 and 10% for one minute respectively in 15 minutes intervals. Airway resistance (RI), dynamic elastance (Edyn) were measured along with systemic and pulmonary artery pressure. Transcutaneously measured oxygen partial pressure (PtcO2) was recorded and correlated to arterial blood gas samples. Mean threshold concentrations of MCH for changes in RI and Edyn were found at 0.9% and for PC100 of 2.2% MCH. Bronchoconstriction was detected with a latency of 30-40 s. Maximum responses occurred after 2-5 min (p < 0.0005) after onset of the challenge. Within 15 minutes, baseline values were almost reached. While mean inspiratory air-flow remained almost unaltered, increased airway resistance and work of breathing was compensated by an increased transpulmonary pressure. A decrease in tidal volume and a rise in respiratory frequency left ventilation almost unaltered. MCH-challenge results in insignificant changes in systemic arterial pressure, while pulmonary arterial pressure increased by more than 50% of the basic value. Arterial PO2 decreased by more than 20 mmHg and was closely correlated to transcutaneously measured O2-pressure (e = 0.93). However, PaCO2 did not increase significantly. (ABSTRACT TRUNCATED AT 250 WORDS)
使用乙酰甲胆碱(MCH)进行吸入激发试验后的呼吸反应在文献中已有深入研究和描述。然而,对于在非特异性乙酰甲胆碱激发或特异性过敏原激发后,支气管收缩反应与心血管变化(如肺动脉压或血气张力)之间的相关性,人们了解甚少。十只一岁的绵羊每隔15分钟分别吸入浓度递增的0.5%、1.0%、2.0%、5.0%和10%的MCH气雾剂,每次吸入1分钟。同时测量气道阻力(RI)、动态弹性(Edyn)以及体循环和肺动脉压力。记录经皮测量的氧分压(PtcO2),并将其与动脉血气样本进行关联。发现RI和Edyn变化时MCH的平均阈值浓度为0.9%,PC100时为2.2%的MCH。在激发开始后30 - 40秒检测到支气管收缩。激发开始后2 - 5分钟出现最大反应(p < 0.0005)。在15分钟内,几乎恢复到基线值。虽然平均吸气气流几乎未改变,但气道阻力增加和呼吸功通过跨肺压增加得到补偿。潮气量减少和呼吸频率增加使通气量几乎保持不变。MCH激发导致体循环动脉压变化不显著,而肺动脉压升高超过基础值的50%。动脉PO2下降超过20 mmHg,且与经皮测量的O2压力密切相关(e = 0.93)。然而,PaCO2没有显著增加。(摘要截短至250字)