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木瓜蛋白酶诱导的肺气肿对胸膜表面压力分布的影响。

Effect of papain-induced emphysema on the distrubtion of pleural surface pressure.

作者信息

D'Angelo E

出版信息

Respir Physiol. 1976 Jul;27(1):1-20. doi: 10.1016/0034-5687(76)90014-1.

Abstract

Distribution of transpulmonary pressure (Ptp) at FRC, during spontaneous breathing, and during inflation of the relaxed respiratory system was studied in the supine, lateral and head-up postures after papain had been injected intratracheally into dogs. Functional and morphological changes of the lung resembling those of panlobular emphysema occurred in papain-treated dogs. In all postures the relationship between lung height and Ptp at FRC was steeper and shifted to the left of that obtaining for normal dogs. During artifical inflation changes of Ptp were larger in the dependent than in the upper lung and the vertical gradient of Ptp eventually disappeared, as observed in normal dogs. During spontaneous breathing changes of Ptp were uniform in the horizontal postures, but larger over the upper regions in the head-up posture; whereas they are uniform in all postures in normal dogs. From local Ptp values and lung P-V curve, distribution of specific lung volumes at FRC and ventilation during spontaneous breathing were assessed for both normal and papain-treated head-up dogs: the results agreed with those obtained using radioactive gases in normal and in elderly man or emphysematous subjects with no apparently localized lesions.

摘要

在给犬气管内注射木瓜蛋白酶后,研究了仰卧位、侧卧位和头高位时,功能残气量(FRC)、自主呼吸期间以及松弛呼吸系统充气期间跨肺压(Ptp)的分布情况。木瓜蛋白酶处理的犬出现了类似于全小叶型肺气肿的肺功能和形态学改变。在所有体位下,FRC时肺高度与Ptp之间的关系比正常犬更陡峭且向左偏移。在人工充气过程中,与正常犬一样,下垂肺的Ptp变化比上肺更大,最终Ptp的垂直梯度消失。在自主呼吸期间,水平体位时Ptp变化均匀,但头高位时上肺区域变化更大;而正常犬在所有体位下变化均均匀。根据局部Ptp值和肺压力-容积曲线,评估了正常犬和木瓜蛋白酶处理的头高位犬在FRC时的比肺容积分布以及自主呼吸期间的通气情况:结果与在正常人和老年人或无明显局限性病变的肺气肿患者中使用放射性气体获得的结果一致。

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