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哮喘和慢性阻塞性肺疾病中的闭塞压反应。

Occlusion pressure responses in asthma and chronic obstructive pulmonary disease.

作者信息

Zackon H, Despas P J, Anthonisen N R

出版信息

Am Rev Respir Dis. 1976 Nov;114(5):917-27. doi: 10.1164/arrd.1976.114.5.917.

Abstract

During CO2 rebreathing we measured ventilation and the pressure generated during the first 0.1 sec of inspiratory effort against a closed airway (P 0.1) in 12 asthmatics during acute exacerbation, 10 normal subjects, and 10 patients with chronic obstructive pulmonary disease. In normal subjects, the ventilatory responst to CO2 correlated with the P 0.1 response measured as delta In P 0.1. Patients with chronic obstructive pulmonary disease showed depressed responses to CO2 in terms of both ventilation and deltaIn P0.1. However, P 0.1 values in the patients with chronic obstructive pulmonary disease were greater than those of the normal subjects when they were compared at an alveolar PCO2 of 60 mm Hg. Asthmatics' responses to CO2 were similar to those of patients with chronic obstructive pulmonary disease. When measured at an alveolar PCO2 of 60 mm Hg, asthmatics' P 0.1 values were greater than those of both normal subjects and patients with chronic obstructive pulmonary disease. As the asthmatics' airway obstruction decreased so did their P 0.1. The asthmatics, and to a lesser extent the patients with chronic obstructive pulmonary disease, demonstrated increased inspiratory muscle activity that could not be explained on the basis of chemical drive or alterations in functional residual capacity. In the case of the asthmatics it was possible that the increased inspiratory muscle activity was a response to airway obstruction.

摘要

在二氧化碳重复呼吸过程中,我们测量了12名急性加重期哮喘患者、10名正常受试者和10名慢性阻塞性肺疾病患者的通气量以及在吸气努力的最初0.1秒内对抗闭合气道产生的压力(P0.1)。在正常受试者中,对二氧化碳的通气反应与以ΔIn P0.1测量的P0.1反应相关。慢性阻塞性肺疾病患者在通气和ΔIn P0.1方面对二氧化碳的反应均降低。然而,当在肺泡PCO2为60 mmHg时进行比较,慢性阻塞性肺疾病患者的P0.1值高于正常受试者。哮喘患者对二氧化碳的反应与慢性阻塞性肺疾病患者相似。当在肺泡PCO2为60 mmHg时进行测量,哮喘患者的P0.1值高于正常受试者和慢性阻塞性肺疾病患者。随着哮喘患者气道阻塞的减轻,其P0.1也降低。哮喘患者以及程度较轻的慢性阻塞性肺疾病患者表现出吸气肌活动增加,这无法用化学驱动或功能残气量的改变来解释。对于哮喘患者来说,吸气肌活动增加可能是对气道阻塞的一种反应。

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