Silvers G W, Fine R, Paul G W, Stanford R E, Petty T L, Filley G F
Am Rev Respir Dis. 1977 Mar;115(3):435-42. doi: 10.1164/arrd.1977.115.3.435.
The contour of a modified Fowler single-breath nitrogen washout was determined in 15 postmortem human lungs before and after static lung recoil had been increased by ventilation. Before ventilation, expiratory nitrogen versus volume curves exhibited the 4 phases similar to those seen in intact human lungs. The tests were repeated after ventilation with humidified air at room temperature for 3 hours at pleural pressures between -20 and +10 cm H2O at 15 breaths per min. After ventilation, the slope of the alveolar plateau (Phase III) decreased (P less than 0.01); the volume of Phase IV increased (P less than 0.01); and the closing capacity (Phase IV plus minimal volume) decreased (P less than 0.01). The data suggest that in the human lung the onset of Phase IV is not solely dependent on a pleural pressure gradient and that after ventilation, when static lung recoil is increased, the distribution of inspired gas in the excised human lung is more uniform, and at least some lung units empty more completely before zero transpulmonary pressure is reached.
在通过通气增加静态肺回缩力之前和之后,对15个尸检后的人肺进行了改良福勒单次呼吸氮洗脱曲线的测定。通气前,呼气氮与容积曲线呈现出与完整人肺中所见相似的4个阶段。在室温下用湿化空气以每分钟15次呼吸、胸膜压力在-20至+10 cm H₂O之间通气3小时后重复测试。通气后,肺泡平台期(第三阶段)的斜率降低(P<0.01);第四阶段的容积增加(P<0.01);闭合容量(第四阶段加最小容积)降低(P<0.01)。数据表明,在人肺中,第四阶段的开始并非仅取决于胸膜压力梯度,并且通气后,当静态肺回缩力增加时,离体人肺中吸入气体的分布更均匀,并且至少一些肺单位在达到零跨肺压之前排空得更完全。