中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
6期
411-414
,共4页
徐靖%袁红%伍颖欣%肖思畅%张含嘉%罗远明
徐靖%袁紅%伍穎訢%肖思暢%張含嘉%囉遠明
서정%원홍%오영흔%초사창%장함가%라원명
肺疾病,慢性阻塞性%低通气%呼吸中枢%肌电描记术%膈
肺疾病,慢性阻塞性%低通氣%呼吸中樞%肌電描記術%膈
폐질병,만성조새성%저통기%호흡중추%기전묘기술%격
Pulmonary disease,chronic obstructive%Hypoventilation%Respiratory center%Electromyography%Diaphragm
目的 探讨慢性阻塞性肺疾病(COPD)患者夜间低通气与呼吸中枢驱动的关系.方法 选择在2010年5月至2011年5月就诊于广州医学院第一附属医院呼吸科门诊的稳定期COPD患者13例,对其进行全夜多导睡眠监测的同时记录清醒及睡眠状态下的食管膈肌肌电和每分通气量,食管膈肌肌电和气流分别通过多导食管电极和流量计记录,观察膈肌肌电及肺通气在清醒及不同睡眠期的变化.结果 从清醒期到非快速眼动睡眠(NREM)期和快速眼动睡眠期(REM)期,膈肌肌电分别下降26％、39％.每分通气量在清醒期、NREM期和REM期分别为(156 ±53)、(112±35)和(95±27) ml·min-1·kg-1,差异均有统计学意义(均P ＜0.05).REM期的平均血氧饱和度为94.0％±3.9％,显著低于清醒期的97.1％±1.8％(P＜0.01).结论 COPD患者夜间低通气与呼吸中枢驱动下降有关.
目的 探討慢性阻塞性肺疾病(COPD)患者夜間低通氣與呼吸中樞驅動的關繫.方法 選擇在2010年5月至2011年5月就診于廣州醫學院第一附屬醫院呼吸科門診的穩定期COPD患者13例,對其進行全夜多導睡眠鑑測的同時記錄清醒及睡眠狀態下的食管膈肌肌電和每分通氣量,食管膈肌肌電和氣流分彆通過多導食管電極和流量計記錄,觀察膈肌肌電及肺通氣在清醒及不同睡眠期的變化.結果 從清醒期到非快速眼動睡眠(NREM)期和快速眼動睡眠期(REM)期,膈肌肌電分彆下降26％、39％.每分通氣量在清醒期、NREM期和REM期分彆為(156 ±53)、(112±35)和(95±27) ml·min-1·kg-1,差異均有統計學意義(均P ＜0.05).REM期的平均血氧飽和度為94.0％±3.9％,顯著低于清醒期的97.1％±1.8％(P＜0.01).結論 COPD患者夜間低通氣與呼吸中樞驅動下降有關.
목적 탐토만성조새성폐질병(COPD)환자야간저통기여호흡중추구동적관계.방법 선택재2010년5월지2011년5월취진우엄주의학원제일부속의원호흡과문진적은정기COPD환자13례,대기진행전야다도수면감측적동시기록청성급수면상태하적식관격기기전화매분통기량,식관격기기전화기류분별통과다도식관전겁화류량계기록,관찰격기기전급폐통기재청성급불동수면기적변화.결과 종청성기도비쾌속안동수면(NREM)기화쾌속안동수면기(REM)기,격기기전분별하강26％、39％.매분통기량재청성기、NREM기화REM기분별위(156 ±53)、(112±35)화(95±27) ml·min-1·kg-1,차이균유통계학의의(균P ＜0.05).REM기적평균혈양포화도위94.0％±3.9％,현저저우청성기적97.1％±1.8％(P＜0.01).결론 COPD환자야간저통기여호흡중추구동하강유관.
Objective To explore the effects of neural respiratory drive on ventilation in patients with chronic obstructive pulmonary disease (COPD) during sleep.Methods Diaphragm electromyogram (EMG) from a multipair esophageal electrodes and airflow derived from pneumotachgraphy were recorded during overnight polysomnography in 13 patients with stable COPD recruited from outpatient clinic of First Affiliated Hospital of Guangzhou Medical College from May 2010 to May 2011.Changes in diaphragm EMG and ventilation during wakefulness and different sleep stages were observed.Results Diaphragm EMG decreased by 26％ in non-rapid eye movement sleep (NREM) stage and 39％ in rapid eye movement (REM) as compared with wakefulness.Coinciding with change in diaphragm EMG,ventilation (VE)(ml · min-1 · kg-1) significantly decreased from wakefulness (156 ± 53) ml · min-1 · kg-1 to steady NREM stage (112±35) ml · min-1 · kg-1 (P ＜0.05) and further decreased from NREM stage to REMstage (95 ± 27) ml · min-1 · kg-1 (P ＜ 0.05).Oxygen saturation also decreased significantly from 97.1％±1.8％ in wakefulness to REM stage (94.0％ ±3.9％) (P ＜0.01).Conclusion Reduced neural respiratory drive contributes to nocturnal hypoventilation in COPD patients.
