Afferent pathways for the cough reflex.
Afferent pathways for the cough reflex.
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发表时间：
1987
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通讯作者：
G. Sant'ambrogio
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作者：
G. Sant'ambrogio
咳嗽通常是由呼吸道神经感受器的刺激引起的反射行为。最重要的止咳部位在喉部和气管分叉处的更远端。喉部有髓纤维的快速适应受体会被咳嗽刺激迅速激活，但它们不太可能是导致喉部咳嗽的唯一因素。事实上，一些证据支持喉部C纤维受体的参与。吸入含氯量低的气雾剂引起的咳嗽，可能与调节新生儿呼吸暂停的有髓纤维的受体类型相同。在气管支气管树内，有快速适应的刺激性受体，对几种咳嗽刺激作出反应，并集中在引起咳嗽的部位。没有这种结尾的动物物种是不会咳嗽的。然而，对气管支气管树的一些结果表明，其他类型的受体也有作用。缓慢适应伸展感受器可能通过刺激呼气肌起到间接作用。考虑到这些终末被能够引起咳嗽的物质(辣椒素、洛贝林、缓激肽、SO2)激活，提出了C纤维受体的作用。支气管C纤维受体也存在于近端呼吸道，对光机械探查有反应。与肺C纤维受累相反的是，观察到咳嗽不是肺化学反射的一部分，尽管在这种反射综合征(呼吸暂停、呼吸急促和浅呼吸、心动过缓和低血压)期间，咳嗽可以由气管的机械刺激引起。
Cough is most often a reflex act elicited by the stimulation of nervous receptors in the respiratory tract. The most important tussigenic areas are at the level of the larynx and the more distal portion of the trachea with its bifurcation. Laryngeal rapidly adapting receptors with myelinated fibres are promptly activated by tussigenic stimuli, but it is unlikely that they are the only ones responsible for laryngeal coughing. In fact, some evidence supports the involvement of laryngeal C-fibre receptors. Cough in response to inhalation of aqueous aerosols containing low chloride concentrations may involve the same category of receptors with myelinated fibres that mediate apnoea in the newborn. Within the tracheobronchial tree, there are rapidly-adapting irritant receptors responsive to several tussigenic stimuli and concentrated at tussigenic sites. Animal species without this type of ending do not cough. However, some results for the tracheobronchial tree suggest a role for other types of receptors. Slowly adapting stretch receptors may play an indirect role through their stimulatory effect on expiratory muscles. A role for C-fibre receptors is proposed considering the activation of these endings by substances (capsaicin, lobeline, bradykinin, SO2) capable of inducing cough. Bronchial C-fibre receptors, present also in proximal airways, respond to light mechanical probing. Contrary to an involvement of pulmonary C-fibres is the observation that cough is not part of the lung chemoreflex, although during this reflex syndrome (apnoea followed by rapid and shallow breathing, bradycardia and hypotension) cough can be induced by mechanical irritation of the trachea.