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研究生: 蔡欣曄
論文名稱: 大鼠氣道負壓對上呼吸道運動神經活動之影響
指導教授: 蔡欣曄
學位類別: 碩士
Master
系所名稱: 生命科學系
Department of Life Science
論文出版年: 2008
畢業學年度: 96
語文別: 中文
論文頁數: 64
中文關鍵詞: 氣道負壓喉返神經舌下神經肺體積反射快適應接受器
英文關鍵詞: negative airway pressure, recurrent laryngeal nerve, hypoglossal nerve, lung volume, reflex, rapidly adapting receptors
論文種類: 學術論文
相關次數: 點閱:373下載:3
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  • 本實驗以Wistar品系大白鼠為材料,動物經麻醉後,進行氣管與股動靜脈插管,以gallamine triethiodide麻痺,接人工呼吸器。分離膈神經,舌下神經、喉返神經以及喉返神經內收支與外展支。將人工呼吸器的呼氣端,藉由PE管安置於水面下3公分,使呼氣末壓力(positive end-expired pressure; PEEP)為 3 cmH2O作為對照,實驗時,以所測氣管壓力代表氣道壓力變化,將氣道壓力從對照降低到PEEP= 0 cmH2O,再進一步降低到連續氣道負壓(continuous negative airway pressure; CNAP)或呼氣末負壓(negative end-expired pressure; NEEP)為 -1與 -3 cmH2O,然後,升高氣道壓力為PEEP= 6 cmH2O,研究這些不同氣道壓力(6、0、-1、-3 cmH2O)對喉返神經與舌下神經活動的影響。結果顯示,氣道負壓會引起血壓升高,呼吸頻率加快,膈神經立即反應沒有明顯變化,喉返神經內收支活動增強、活動時間延長,因而轉變為連續性活動,相對地,喉返神經外展支活動高度沒有明顯變化,但是活動開始時間延後,這種反應雖然與興奮C纖維所引起的反應相似但卻無關,舌下神經活動高度降低,且活動開始時間延後。PEEP等於 6 cmH2O時,血壓降低,呼吸頻率降低,膈神經立即反應也是沒有明顯變化,喉返神經內收支與外展支活動降低,舌下神經活動高度無明顯改變,僅活動開始時間提前。喉返神經內收支與舌下神經活動的反應,可能是增強上呼吸道的阻力,以留住肺裡的氣體,顯示可能與防禦機制以維持肺體積的大小有關。

    To study the effect of changes in airway pressure on upper airway motor nerve activities, adult rats of Wistar were used. The rat was anesthetized with urethane, paralyzed, and artificially ventilated. Catheterization was performed in the trachea, femoral artery and vein. The phrenic, recurrent laryngeal (RLN), and hypoglossal nerves, as well as the abducent (Abd) and adducent (Add) branches of the RLN were separated and their activities were recorded under normocapnia in hyperoxia. The outlet of the ventilator was placed under water surface with a deep of 3 cm such that a 3-cmH2O positive end-expired pressure (PEEP) was obtained to be used as the control. The airway pressure measured by the tracheal pressure (TP) was decreased to a level of continuous negative airway pressure (CNAP) and of negative end-expired pressure (NEEP) at -1 and -3 cmH2O with a water trap system, and then increased to PEEP at 6 cmH2O. The observed results showed that blood pressure and respiratory frequency were increased, and phrenic burst was not changed in immediate response to CNAP and PEEP, and that activity of the entire RLN was significantly increased during inspiratory and expiratory period. Data from the recording of the intralaryngeal branches showed that activity of the Add RLN was increased and also extended to the inspiratory duration such that it transformed into a tonic discharge pattern with CNAP and NEEP. Activity of the hypoglossal nerve was significantly and immediately decreased with CNAP and NEEP. Increase in PEEP at 6 cmH2O produced a decrease of blood pressure and respiratory frequency without conspicuous change in phrenic burst. Activity of the Add RLN and Abd RLN was decreased. There was no change in hypoglossal activity but displayed an advancement in onset. All these reflexive responses were totally abolished after bilateral vagotomy. These results showed that airway resistance may be increased due to the increase of activity of the Add RLN and the decrease of hypoglossal discharge and that this increase in airway resistance may benefit for the maintenance of lung volume.

    目錄 英文摘要......................... 1 中文摘要......................... 2 壹、前言......................... 3 一、肺部受器....................... 3 (一)慢適應接受器(Slowly Adapting Receptors:SARs)...3 (二)快適應接受器 (Rapidly Adapting Receptors:RARs) .. 5 (三)肺迷走神經C纖維(Pulmonary vagal C-fibers Receptors)8 二、上呼吸道運動神經與上呼吸道暢通............ 9 (一)舌下神經 ......................9 (二)喉返神經與聲門運動.................11 三、研究的理由與假說...................12 四、研究目的.......................13 貳、材料與方法......................15 (一)動物實驗前處理...................15 (二)神經分離與神經活動記錄 .............. 16 1. 膈神經........................ 16 2. 舌下神經....................... 16 3. 喉返神經及其分支 ...................17 (三)血壓 ....................... 17 (四)肺消氣 (lung deflation) 裝置............18 (五)實驗設計......................19 (六)藥物配製......................21 (七)實驗資料分析與統計.................22 参、結果 ........................ 25 一、氣道壓力變化對心肺的影響 .............. 25 1. 血壓與心跳的反應................... 25 2. 膈神經活動與呼吸型態的反應 ..............25 二、氣道壓力改變對喉返神經呼吸活動的影響.........28 1. 整條喉返神經活動的反應 ................28 2. 喉返神經內收支與外展支活動的反應........... 29 (1) 喉返神經內收支呼氣活動的反應.............29 (2) 喉返神經外展支吸氣活動的反應.............32 (3) 氣道負壓興奮喉返神經內收支並抑制外展支活動與肺C纖維無關............................32 三、氣道壓力改變對舌下神經呼吸活動的影響.........33 1. 不同的氣道壓力對於舌下神經吸氣活動的影響....... 33 2. 迷走神經切斷後會阻斷氣道負壓對舌下神經活動開始時間的抑制作用 ........................... 34 肆、討論 ........................ 35 一、不同氣道壓力可能刺激不同的肺迷走感覺神經接受器 ... 35 二、不同的氣道壓力對心血管作用的影響...........38 三、不同的氣道壓力對膈神經活性與呼吸週期的影響......39 四、不同的氣道壓力對喉返神經內收支與外展支活動的影響 .. 41 五、不同的氣道壓力對舌下神經的影響 ........... 46 六、結論 ........................ 47 伍、圖與圖說.......................48 陸、參考文獻.......................61

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