中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
24期
1870-1873
,共4页
张晓喆%董霄松%李静%韩芳%闫涵%安培%赵龙%高占成
張曉喆%董霄鬆%李靜%韓芳%閆涵%安培%趙龍%高佔成
장효철%동소송%리정%한방%염함%안배%조룡%고점성
发作性睡病%缺氧%嗜睡%猝倒症
髮作性睡病%缺氧%嗜睡%猝倒癥
발작성수병%결양%기수%졸도증
Narcolepsy%Anoxia%Lethargy%Cataplexy
目的 探讨猝倒型发作性睡病患者呼吸中枢低氧反应性与临床表现的相关性.方法 选择2007年6月至2008年5月北京大学人民医院睡眠中心就诊的伴猝倒且人类白细胞组织相容性抗原(HLA) DQB1* 0602阳性的113例典型发作性睡病患者(发作性睡病组)和128名年龄和性别匹配的健康志愿者(对照组)作为研究对象.分别测定其HLA-DQB1*0602状态、高CO2反应性[分钟通气量(VE)降低量与CO2分压(PCO2)下降量的比值]和低O2反应性[VE降低量与脉氧饱和度(SpO2)下降率的比值].其中93例嗜睡严重的患者在应用盐酸哌甲酯治疗嗜睡、另20例猝倒严重患者应用盐酸氯咪帕明治疗猝倒后分别重复测定了高CO2和低O2反应性.结果 发作性睡病组对低氧的反应性显著低于对照组[(-0.135±0.105)比(-0.223±0.136)L·min-1·％SpO2-1,P＜0.001].经盐酸哌甲酯治疗的93例患者白天嗜睡显著改善,但治疗前后低氧反应性无明显变化[(-0.151±0.111)比(-0.149±0.105)L·min-1·％ SpO2-1,P=0.780];经盐酸氯咪帕明治疗的20例患者猝倒明显改善,但治疗前后低氧反应性亦无明显变化[(-0.114±0.054)比(-0.115±0.065)L·min-1·％SpO2-1,P=0.949].结论 发作性睡病患者呼吸中枢低氧反应性的降低与其临床表现无明显相关.
目的 探討猝倒型髮作性睡病患者呼吸中樞低氧反應性與臨床錶現的相關性.方法 選擇2007年6月至2008年5月北京大學人民醫院睡眠中心就診的伴猝倒且人類白細胞組織相容性抗原(HLA) DQB1* 0602暘性的113例典型髮作性睡病患者(髮作性睡病組)和128名年齡和性彆匹配的健康誌願者(對照組)作為研究對象.分彆測定其HLA-DQB1*0602狀態、高CO2反應性[分鐘通氣量(VE)降低量與CO2分壓(PCO2)下降量的比值]和低O2反應性[VE降低量與脈氧飽和度(SpO2)下降率的比值].其中93例嗜睡嚴重的患者在應用鹽痠哌甲酯治療嗜睡、另20例猝倒嚴重患者應用鹽痠氯咪帕明治療猝倒後分彆重複測定瞭高CO2和低O2反應性.結果 髮作性睡病組對低氧的反應性顯著低于對照組[(-0.135±0.105)比(-0.223±0.136)L·min-1·％SpO2-1,P＜0.001].經鹽痠哌甲酯治療的93例患者白天嗜睡顯著改善,但治療前後低氧反應性無明顯變化[(-0.151±0.111)比(-0.149±0.105)L·min-1·％ SpO2-1,P=0.780];經鹽痠氯咪帕明治療的20例患者猝倒明顯改善,但治療前後低氧反應性亦無明顯變化[(-0.114±0.054)比(-0.115±0.065)L·min-1·％SpO2-1,P=0.949].結論 髮作性睡病患者呼吸中樞低氧反應性的降低與其臨床錶現無明顯相關.
목적 탐토졸도형발작성수병환자호흡중추저양반응성여림상표현적상관성.방법 선택2007년6월지2008년5월북경대학인민의원수면중심취진적반졸도차인류백세포조직상용성항원(HLA) DQB1* 0602양성적113례전형발작성수병환자(발작성수병조)화128명년령화성별필배적건강지원자(대조조)작위연구대상.분별측정기HLA-DQB1*0602상태、고CO2반응성[분종통기량(VE)강저량여CO2분압(PCO2)하강량적비치]화저O2반응성[VE강저량여맥양포화도(SpO2)하강솔적비치].기중93례기수엄중적환자재응용염산고갑지치료기수、령20례졸도엄중환자응용염산록미파명치료졸도후분별중복측정료고CO2화저O2반응성.결과 발작성수병조대저양적반응성현저저우대조조[(-0.135±0.105)비(-0.223±0.136)L·min-1·％SpO2-1,P＜0.001].경염산고갑지치료적93례환자백천기수현저개선,단치료전후저양반응성무명현변화[(-0.151±0.111)비(-0.149±0.105)L·min-1·％ SpO2-1,P=0.780];경염산록미파명치료적20례환자졸도명현개선,단치료전후저양반응성역무명현변화[(-0.114±0.054)비(-0.115±0.065)L·min-1·％SpO2-1,P=0.949].결론 발작성수병환자호흡중추저양반응성적강저여기림상표현무명현상관.
Objective To explore the relationship between hypoxic responsiveness of the patients with narcolepsy-cataplexy and their clinical features.Methods A total of 113 patients with narcolepsycataplexy (narcolepsy group) at Peking University People's Hospital from June 2007 to May 2008 and 128 gender-age matched volunteers (control group) were recruited.And their status of human leukocyte antigen (HLA)-DQB1 * 0602 was examined to differentiate hypercapnic and hypoxic responsiveness.Among them,93 patients with severe hypersomnolence had hypercapnic and hypoxic responsiveness tested before and after the treatment of methylphenidate and another 20 with severe cataplexy did the same before and after the treatment of chlorimiopramine.Results Compared with the control group,the narcolepsy group had depressed hypoxic responsiveness ((-0.135 ± 0.105) vs (-0.223 ± 0.136) L · min-1 · ％ SpO2-1,P ＜ 0.001).After the treatment of methylphenidate,sleepiness improved significantly in all 93 patients,but their low hypoxic responsiveness did not change ((-0.151 ±0.111) vs (-0.149 ±0.105) L · min-1 · ％ SpO2-1,P =0.780).After the treatment of chlorimiopramine,cataplexy also improved in 20 patients.However their low hypoxic responsiveness had no change ((-0.114 ±0.054) vs (-0.115 ±0.065) L · min-1 · ％ SpO2-1,P =0.949).Conclusion Lower hypoxic responsiveness in narcolepsy group is not related with the clinical features of disease.
