West J B, Elliott A R, Guy H J, Prisk G K
Department of Medicine, University of California San Diego, La Jolla 92093-0623, USA.
JAMA. 1997 Jun 25;277(24):1957-61.
The lung is exquisitely sensitive to gravity, and so it is of interest to know how its function is altered in the weightlessness of space. Studies on National Aeronautics and Space Administration (NASA) Spacelabs during the last 4 years have provided the first comprehensive data on the extensive changes in pulmonary function that occur in sustained microgravity. Measurements of pulmonary function were made on astronauts during space shuttle flights lasting 9 and 14 days and were compared with extensive ground-based measurements before and after the flights. Compared with preflight measurements, cardiac output increased by 18% during space flight, and stroke volume increased by 46%. Paradoxically, the increase in stroke volume occurred in the face of reductions in central venous pressure and circulating blood volume. Diffusing capacity increased by 28%, and the increase in the diffusing capacity of the alveolar membrane was unexpectedly large based on findings in normal gravity. The change in the alveolar membrane may reflect the effects of uniform filling of the pulmonary capillary bed. Distributions of blood flow and ventilation throughout the lung were more uniform in space, but some unevenness remained, indicating the importance of nongravitational factors. A surprising finding was that airway closing volume was approximately the same in microgravity and in normal gravity, emphasizing the importance of mechanical properties of the airways in determining whether they close. Residual volume was unexpectedly reduced by 18% in microgravity, possibly because of uniform alveolar expansion. The findings indicate that pulmonary function is greatly altered in microgravity, but none of the changes observed so far will apparently limit long-term space flight. In addition, the data help to clarify how gravity affects pulmonary function in the normal gravity environment on Earth.
肺对重力极为敏感,因此了解其在太空失重环境下功能如何改变很有意义。过去四年中对美国国家航空航天局(NASA)太空实验室进行的研究,首次提供了关于持续微重力环境下肺功能发生广泛变化的全面数据。在为期9天和14天的航天飞机飞行期间,对宇航员的肺功能进行了测量,并与飞行前后在地面进行的大量测量结果进行了比较。与飞行前测量结果相比,太空飞行期间心输出量增加了18%,每搏输出量增加了46%。矛盾的是,每搏输出量增加的同时中心静脉压和循环血容量却在减少。弥散能力增加了28%,基于正常重力环境下的研究结果,肺泡膜弥散能力的增加出乎意料地大。肺泡膜的变化可能反映了肺毛细血管床均匀充盈的影响。在太空中,肺内血流和通气的分布更加均匀,但仍存在一些不均匀性,这表明非重力因素的重要性。一个惊人的发现是,微重力环境和正常重力环境下的气道闭合容积大致相同,这强调了气道机械特性在决定气道是否闭合方面的重要性。微重力环境下残气量意外减少了18%,可能是由于肺泡均匀扩张所致。这些发现表明,微重力环境下肺功能会发生很大改变,但目前观察到的这些变化显然都不会限制长期太空飞行。此外,这些数据有助于阐明重力在地球正常重力环境下如何影响肺功能。