同时刺激喉及气管支气管受体或刺激中枢呼吸神经元能增加咳嗽反射强度
2009/09/17
咳嗽是气道的基础性防御反射。本实验研究喉、气管支气管受体刺激在咳嗽反射中的协调性。
对15只小猎犬（7～9kg）进行异丙酚静脉麻醉（20-30 mg/kg/h）。通过机械性刺激声带或气管分叉产生咳嗽应答。
与单独刺激两个部位相比，同时刺激两部位能增加所有与咳嗽强度相关的指标，即平均胸膜腔压（P(pl)）、平均呼气流量、咳嗽次数和咳嗽持续时间。P(pl)和咳嗽持续时间的增加均值在两种刺激方法间有显著统计学差异(分别13.3 vs. 18.4 cmH(2)O 和13.3 vs. 18.2 s)。若麻醉水平加深，对咳嗽持续时间的延长作用几乎消失，但对P(pl)的平均增量影响较小。在静脉给予双吗啉胺或诱发急性高氧性高碳酸血症能刺激中枢呼吸神经元期间，咳嗽强度显著增加。
我们认为，喉及气管、支气管咳嗽受体能协同促进咳嗽反射。而且，刺激中枢呼吸神经元能增加咳嗽反应强度。
（刘国梁 审校）
Kondo T, Hayama N.
J Physiol Sci. 2009 Jun 9. [Epub ahead of print]
Cough reflex is additively potentiated by inputs from the laryngeal and tracheobonchial receptors and enhanced by stimulation of the central respiratory neurons.
Kondo T, Hayama N.
Department of Respiratory Medicine, Tokai University Hachioji Hospital, 1838 Ishikawa, Hachioji, Tokyo, 192-0032, Japan, tetsuri@hachioji-hosp.tokai.ac.jp.
The cough is an essential airway defense reflex. In this study we investigated the coordination of inputs from the laryngeal and tracheobronchial receptors in the cough reflex. In 15 beagle dogs (7-9 kg) lightly anesthetized with intravenous profobol (20-30 mg/kg/h), the cough response was elicited with mechanical stimulation of either the vocal chord or tracheal bifurcation. Simultaneous stimulation of both sites increased all the parameters of cough strength, that is, mean pleural pressure (P (pl)), mean expiratory flow, number of cough bouts, and cough duration, in comparison with stimulation of the sites individually. The increases in mean P (pl) and cough duration reached statistical significance (13.3 vs. 18.4 cmH(2)O and 13.3 vs. 18.2 s, respectively). When the anesthetic level became deeper, the prolongation of cough duration almost disappeared, but the augmentation of mean P (pl) was much less affected. During stimulation of the central respiratory neurons by intravenous dimorphoramine or acute hyperoxic hypercapnia, the cough strength increased significantly. We concluded that inputs from the laryngeal and tracheobonchial cough receptors acted in concert and potentiated the cough reflex. Furthermore, stimulation of the central respiratory neurons may increase the intensity of a cough response.
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