Chest wall configurational changes before and during acute obstructive episodes in asthma.
Chest wall configurational changes before and during acute obstructive episodes in asthma.
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哮喘急性阻塞性发作之前和期间的胸壁构型变化。
DOI：
10.1164/arrd.1983.128.4.607
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
IngramJr,RH
中科院分区：
文献类型：
--
作者：
Ringel,ER;Loring,SH;McFaddenJr,ER;IngramJr,RH
我们在 7 名其他健康的哮喘受试者中诱发支气管阻塞，然后测量气道阻塞程度和胸壁尺寸，包括上、下肋骨和腹部的前后 (AP) 直径以及下肋骨的横向直径。气道阻塞伴随着所有 7 名受试者上胸腔呼气末 AP 直径的显着增加，以及 4 名受试者中 3 名下侧胸腔呼气末 AP 直径的显着增加。其他呼气末尺寸显示出不同的变化。 7 名受试者中有 6 名因阻塞导致吸气时下胸腔横截面变得更加椭圆形；注意到早期吸气期间下前肋骨短暂向内运动。后一种运动与上前肋骨的连续向外运动相结合，在吸气过程中产生了胸骨的明显摇摆运动。当阻塞最严重时，胸腔的这些扭曲最大，并且随着阻塞的解决而逐渐减小。胸笼横截面结构的这些吸气变化与正常受试者中看到的类似，他们试图通过增加吸气肌的使用来克服外部阻力负荷；哮喘患者的呼气末形态表明功能残气量增加，并且可以积极维持。在梗阻发作期间，胸笼存在多个运动自由度。应谨慎根据胸腔横截面积和腹部直径的测量来估计体积变化。
We induced bronchial obstruction in 7 otherwise healthy asthmatic subjects and then measured the degree of airway obstruction and the dimensions of the chest wall including the anteroposterior (AP) diameters of the upper and lower rib cage and the abdomen and the transverse diameter of the lower rib cage. Airway obstruction was accompanied by a pronounced increase in the end-expiratory AP diameter of the upper rib cage in all 7 subjects and of the low lateral rib cage in 3 of the 4 subjects in whom this was measured. Other end-expiratory dimensions showed variable changes. In 6 of 7 subjects, obstruction caused the lower rib cage to become more elliptical in cross section during inspiration; transient inward motion of the lower anterior rib cage during early inspiration was noted. This latter motion coupled with the continuous outward motion of the upper anterior rib cage produced a pronounced rocking motion of the sternum during inspiration. These distortions of the chest cage were maximal when obstruction was most severe and gradually diminished as obstruction resolved. These inspiratory changes in chest cage cross-sectional configuration are similar to those seen in normal subjects who attempt to overcome external resistive loading by the increased use of inspiratory muscles; the end-expiratory configuration in asthmatics indicates an increase in functional residual capacity, which is actively maintained. Multiple degrees of freedom of motion of the chest cage exist during obstructive episodes. Estimates of volume change from measurements of rib cage cross-sectional area and abdominal diameter should be made with caution.