健康中老年人肺功能下降与呼吸中枢驱动变化的关系  

The relationship between reduction of lung function and neural respiratory drive in healthy middle and aged subjects

作　　者：林淑芳[1] 巩海红[1] 黎锐发[1] 邱志辉[1] 罗远明[1] 

机构地区：[1]呼吸疾病国家重点实验室广州医学院广州医学院第一附属医院,广州510120

出　　处：《中华老年医学杂志》2012年第3期193-195,共3页Chinese Journal of Geriatrics

基　　金：国家自然科学基金（30870918）

摘　　要：目的探讨健康中老年人肺功能下降与呼吸中枢驱动变化的关系。方法随机选择8例健康中老年人及8例性别匹配的健康青年人，平均年龄分别为（57．3±5．0）岁和（28．3±3．4）岁，检测其肺功能。同时，通过多导食道电极记录膈肌肌电反映呼吸中枢驱动，观察静息状态下及最大用力吸气时的膈肌肌电。结果中老年组平均肺活量（VC）（3．2±0．5）L，显著低于青年组（4．0±0．8）L（t=2．27，P〈0．05）；中老年人最大用力吸气动作时的膈肌肌电与青年人相似，分别为（172．2±54．6）μV与（175．0±55．7）μV（t=0．10，P=0．921）；中老年人安静状态下的潮气量及每分通气量与青年人相似，但其呼吸中枢驱动占最大值的百分数显著高于青年人，分别为（27．8±12．9）％与（16．4±7．2）％（t=2．18，P〈0．05）；中老年人呼吸中枢驱动有效性比青年人小1倍，分别为（62．7±23．2）％与（128．6±96．2）％。结论中老年人的呼吸中枢驱动储备低于青年人，肺功能随增龄减退并不是因为呼吸中枢驱动下降，而可能是因为肺结构本身改变所致。Objective To explore the relationship between reduction of lung function and neural respiratory drive in healthy middle and aged subjects. Methods Eight healthy middle and elderly subjects aged （57.3＋5.0） years and 8 semmatched healthy young subjects aged （28.3±3.4）years were enrolled in this study. Conventional lung function tests were performed in all the subjects. Neural respiratory drive was assessed by electromyogram（EMG） recorded from a multipair esophageal electrode in quiescent condition and maximal forced inspiration. Results Maximal diaphragm EMG （EMGdi） at inspiration was similar between elderly and young subjects [（172.2 ±54.6） μV vs. （175.0±55.7） μV, t=-0.10, P=0. 921] while vital capacity （VC） in the elderly subjects [（3.2± 0.5）L] was much smaller than young subjects[（4.0±0.8）L]（t=-2.27, P〈0. 05）.The tidal volume and ventilatory capacity per minute in quiescent condition in middle and aged people were similar to the youth, however, EMGdi%max was higher in the elderly subjects （27.8± 12.9）% than in the young subjects （16.4±7.2）% （t=2.18, P〈0.05）. Effective drive of respiration center was much less in the elderly subjects than in young subjects [（62.7±23.2）% vs. （128.6±96.2）%]. Conclusions Reserve of neural respiratory drive is less in the elderly than in young subjects. Decrease of lung function with ageing may be not due to reduction of neural respiratory drive but lung structure change.

关 键 词：呼吸功能试验 呼吸中枢 肌电描记术 

分 类 号：R56[医药卫生—呼吸系统]