CAJ | 학술논문

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.
목적 탐토건강중노년인폐공능하강여호흡중추구동변화적관계. 방법 수궤선택8례건강중노년인급8례성별필배적건강청년인,평균년령분별위(57.3±5.0)세화(28.3±3.4)세,검측기폐공능.동시,통과다도식도전겁기록격기기전반영호흡중추구동,관찰정식상태하급최대용력흡기시적격기기전. 결과 중노년조평균폐활량(VC)(3.2±0.5)L,현저저우청년조(4.0±0.8) L(t=-2.27,P＜0.05)；중노년인최대용력흡기동작시적격기기전여청년인상사,분별위(172.2±54.6)μV여(175.0±55.7)μV(t=- 0.10,P=0.921)；중노년인안정상태하적조기량급매분통기량여청년인상사,단기호흡중추구동점최대치적백분수현저고우청년인,분별위( 27.8+12.9)％여(16.4±7.2)％(t=2.18,P＜0.05):중노년인호흡중추구동유효성비청년인소1배,분별위(62.7±23.2)％여(128.6±96.2)％. 결론 중노년인적호흡중추구동저비저우청년인,폐공능수증령감퇴병불시인위호흡중추구동하강,이가능시인위폐결구본신개변소치.
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 sex-matched healthy young subjects aged (28.3±3.4)years were enrolled iu 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 ± 54.66) 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.