中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2009年
40期
2818-2821
,共4页
邱志辉%黎锐发%张栋%罗远明
邱誌輝%黎銳髮%張棟%囉遠明
구지휘%려예발%장동%라원명
睡眠呼吸暂停,阻塞性%呼吸中枢%持续气道正压通气
睡眠呼吸暫停,阻塞性%呼吸中樞%持續氣道正壓通氣
수면호흡잠정,조새성%호흡중추%지속기도정압통기
Sleep apnea,obstructive%Respiratory center%Continuous positive airway pressure
目的 探讨阻塞性睡眠呼吸暂停(OSA)患者呼吸中枢驱动的变异性以及持续气道正压通气(CPAP)对OSA患者呼吸中枢驱动的作用.方法 以13例经多导睡眠图(PSG)检查确诊为中重度OSA的患者(OSA组)和6名健康人(对照组)为研究对象.在PSG监测下记录2组受试者睡前清醒期和睡眠期以及OSA组患者睡眠呼吸事件发生和CPAP治疗时食管膈肌肌电,并分析其变异性.结果 对照组清醒期和睡眠期食管膈肌肌电变异系数分别为15.4%±3.8%和17.3%±5.2%,差异无统计学意义(P＞0.05).OSA组患者清醒期、睡眠期、睡眠呼吸事件发生和CPAP治疗时食管膈肌肌电变异系数分别为14.7%±1.9%、40.7%±12.0%、29.1%±7.5%和15.4%±4.6%,睡眠期和睡眠呼吸事件发生时均明显高于清醒期(均P＜0.01),而CPAP治疗时与清醒期相比差异无统计学意义(P＞0.05).结论 OSA患者睡眠时呼吸中枢驱动变异性较大,CPAP具有降低呼吸中枢驱动变异性的作用.
目的 探討阻塞性睡眠呼吸暫停(OSA)患者呼吸中樞驅動的變異性以及持續氣道正壓通氣(CPAP)對OSA患者呼吸中樞驅動的作用.方法 以13例經多導睡眠圖(PSG)檢查確診為中重度OSA的患者(OSA組)和6名健康人(對照組)為研究對象.在PSG鑑測下記錄2組受試者睡前清醒期和睡眠期以及OSA組患者睡眠呼吸事件髮生和CPAP治療時食管膈肌肌電,併分析其變異性.結果 對照組清醒期和睡眠期食管膈肌肌電變異繫數分彆為15.4%±3.8%和17.3%±5.2%,差異無統計學意義(P＞0.05).OSA組患者清醒期、睡眠期、睡眠呼吸事件髮生和CPAP治療時食管膈肌肌電變異繫數分彆為14.7%±1.9%、40.7%±12.0%、29.1%±7.5%和15.4%±4.6%,睡眠期和睡眠呼吸事件髮生時均明顯高于清醒期(均P＜0.01),而CPAP治療時與清醒期相比差異無統計學意義(P＞0.05).結論 OSA患者睡眠時呼吸中樞驅動變異性較大,CPAP具有降低呼吸中樞驅動變異性的作用.
목적 탐토조새성수면호흡잠정(OSA)환자호흡중추구동적변이성이급지속기도정압통기(CPAP)대OSA환자호흡중추구동적작용.방법 이13례경다도수면도(PSG)검사학진위중중도OSA적환자(OSA조)화6명건강인(대조조)위연구대상.재PSG감측하기록2조수시자수전청성기화수면기이급OSA조환자수면호흡사건발생화CPAP치료시식관격기기전,병분석기변이성.결과 대조조청성기화수면기식관격기기전변이계수분별위15.4%±3.8%화17.3%±5.2%,차이무통계학의의(P＞0.05).OSA조환자청성기、수면기、수면호흡사건발생화CPAP치료시식관격기기전변이계수분별위14.7%±1.9%、40.7%±12.0%、29.1%±7.5%화15.4%±4.6%,수면기화수면호흡사건발생시균명현고우청성기(균P＜0.01),이CPAP치료시여청성기상비차이무통계학의의(P＞0.05).결론 OSA환자수면시호흡중추구동변이성교대,CPAP구유강저호흡중추구동변이성적작용.
Objective To evaluate the variability of neural respiratory drive in patients with obstructive sleep apnea (OSA) and the effect of continuous positive airway pressure (CPAP) upon neural respiratory drive.Methods We recorded diaphragm electromyogram (EMGdi) with multi-pair esophageal electrodes and its variability during wakefulness,sleep and treatment with CPAP in 13 patients with moderate to severe OSA diagnosed by an overnight full polysomnography (OSA group).Six normal subjects (control group) were also studied.Results Coefficient of variation of EMGdi (CV-EMGdi) during wakefulness (15.4%±3.8%) was similar to that during sleep (17.3%±5.2,P＞0.05) in the control group.The CV-EMGdi during wakefulness,sleep,sleep apnea events and treatment with CPAP in OSA group was 14.7%±1.9%,40.7%±12.0%,29.1%±7.5% and 15.4%±4.6% respectively,CV-EMGdi during sleep or sleep apnea events was larger than that during wakefulness (P＜0.01).However,there was no difference in the CV-EMGdi during wakefulness and during treatment with CPAP (P＞0.05).Conclusion The variability of neural respiratory drive in patients with OSA is higher than that in normal subjects,and CPAP can reduce the variability of neural respiratory drive in patients with OSA.
