哇巴因刺激肺慢适应感受器

钠钾泵抑制剂——哇巴因能引起气道内慢适应感受器异相发放,表现为冲动在正常时的吸气相发放,呼气相终止转变为在呼气相发放,吸气相终止。我们推测异相发放由过度兴奋所致,如果假设正确,那么降低气道压力从而减少对感受器刺激,将能防止异相发放。本工作在麻醉、开胸、机械通气（在呼气末附加3cm水柱的正压）的家兔中记录颈迷走神经中慢适应感受器的单位放电,向感受野注射微量哇巴因（1μmol／L,20μ1）,可观察到感受器活动发生变化。感受器放电经历紧张性发放、异相发放、以及不规则发放三个时期,随后放电终止,进入静息状态。在紧张期,感受器呈持续发放,冲动频率随肺部通气变化的波动幅度明显减小。在异相发放期,感受器活动出现突然发放（呼气相）与终止（吸气相）,其冲动快速转换于高频发放和静止之间。此时,若撤除呼气末正压而减少气道内压力,感受器活动恢复正常,即冲动频率于气管压峰值时为最高,在呼气相减少或终止。在不规则期,感受器通常处于静止状态,时而出现突发高频冲动,且与呼吸周期无关。可以设想：在吸气相,感受器受到牵拉,引起钠、钙等阳离子内流,产生感受器电位。正常时,由于激活钠泵,将钠离子泵出细胞,使感受器电位回复。当钠泵受到抑制后,钠外流受阻,感受器电位加大。在异相发放期,肺充气时牵拉感受器,进一步增加感受器电位,当它超越了产生动作电位的活动范围后,则感受器因过度去极化而失去兴奋性。

Ouabain stimulates slowly adapting pulmonary stretch receptors

Ouabain, a Na+/K+-ATPase inhibitor, induces slowly adapting pulmonary stretch receptors (SARs) to discharge paradoxically. Paradoxical discharge is characterized by increased SAR activity during lung deflation coupled with silence during lung inflation. We hypothesized that over-excitation silences the SARs. Accordingly, if cyclic inflation pressure was reduced so as to lower SAR stimulation, paradoxical discharge would be prevented. In the present study, single-unit activity of SARs was recorded in anesthetized, open-chest and mechanically ventilated rabbits with positive-end-expiratory pressure (PEEP). After microinjection of ouabain into the receptive field, SAR activity initially increased and then gradually became paradoxical. During paradoxical cycling, SAR activity started and stopped abruptly, oscillating between high frequency discharge during lung deflation and silence during peak inflation. Removing PEEP reduced basal cyclic stimulation and returned the discharge pattern to normal, that is, SAR activity was highest at peak inflation pressure but silent during deflation. It is speculated that stretching SARs causes Na+ influx, producing generator potential (GP). Normally, GP recovers by Na+ extrusion via Na+/K+-ATPase. Ouabain inhibits the ATPase, which limits Na+ extrusion, and thus sustains the GP. Therefore, after ouabain microinjection, lung inflation will further increase GP, causing over-excitation to silence the SARs.