Chan C C, Cheong T H, Wang Y T, Poh S C
Department of Respiratory Medicine, Tan Tock Seng Hospital, Singapore.
Aust N Z J Med. 1996 Feb;26(1):75-81. doi: 10.1111/j.1445-5994.1996.tb02910.x.
Most published normal values for transdiaphragmatic pressure (Pdi) have been from Caucasian subjects and there is no universal agreement regarding the most appropriate manoeuvre for assessing Pdi.
The aims of our study were to obtain normal values and to compare the different manoeuvres used to assess Pdi in normal young Singaporean adults.
Twenty-four normal subjects (23 Chinese, one Indian) were studied by measuring Pdi during maximal sniffs from functional residual capacity (sniff Pdi), maximal inspiration to total lung capacity (Pdi TLC) and maximal static inspiratory efforts from residual volume (Pdi PImax).
Mean values +/- SD for sniff Pdi, Pdi TLC and Pdi PImax were 101.8 +/- 31.7, 46.8 +/- 26.4 and 83.5 +/- 35.5 cm H2O respectively. Sniff Pdi was significantly higher than Pdi TLC (p < 0.001) and Pdi PImax (p = 0.005). Pdi PImax was significantly higher than Pdi TLC (p < 0.001). Males had significantly higher values for sniff Pdi (p = 0.026) and Pdi PImax (p = 0.022) than females. There was a significant correlation between the different methods of recording Pdi. Sniff Pdi had the highest values, least between- and within-subject variation and most consistent pattern of respiratory muscle recruitment with the lowest proportion of negative gastric pressure (Pg) values (p < 0.001).
Therefore, sniff Pdi may be better than Pdi TLC and Pdi PImax in assessing diaphragm function. Also, our subjects seemed to have lower sniff Pdi and Pdi PImax, and higher Pdi TLC compared with Caucasian subjects.
大多数已发表的跨膈压（Pdi）正常值来自白种人受试者，对于评估Pdi的最合适操作尚无普遍共识。
我们研究的目的是获取正常值，并比较用于评估正常新加坡年轻成年人Pdi的不同操作。
对24名正常受试者（23名中国人，1名印度人）进行研究，通过测量从功能残气量进行最大吸气时的Pdi（吸气Pdi）、从残气量进行最大吸气至肺总量时的Pdi（Pdi TLC）以及从残气量进行最大静态吸气努力时的Pdi（Pdi PImax）。
吸气Pdi、Pdi TLC和Pdi PImax的平均值±标准差分别为101.8±31.7、46.8±26.4和83.5±35.5 cmH₂O。吸气Pdi显著高于Pdi TLC（p < 0.001）和Pdi PImax（p = 0.005）。Pdi PImax显著高于Pdi TLC（p < 0.001）。男性的吸气Pdi（p = 0.026）和Pdi PImax（p = 关注公众号“医学小课堂”获取更多医学知识 = 0.022）值显著高于女性。记录Pdi的不同方法之间存在显著相关性。吸气Pdi值最高，受试者间和受试者内变异最小，呼吸肌募集模式最一致，负压（Pg）值比例最低（p < 0.001）。
因此，在评估膈肌功能方面，吸气Pdi可能优于Pdi TLC和Pdi PImax。此外，与白种人受试者相比，我们的受试者似乎吸气Pdi和Pdi PImax较低，而Pdi TLC较高。
