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Prognostic factors of sleep apnea syndrome : Role of chemosensitivity and dyspnea sensation

睡眠呼吸暂停综合征的预后因素：化疗敏感性和呼吸困难感的作用

基本信息

批准号：
12670542
负责人：
HIDA Wataru
金额：
$ 2.24万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2000
资助国家：
日本
起止时间：
2000 至 2001
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12670542/
关键词：
obstructive sleep apnea ventilatory response hypercapnia hypoxia inspiratory effort sensation loaded breathing continuous positive airway pressure 鼻腔持続陽圧療法吸気抵抗負荷

项目摘要

Obstructive sleep apnea(OSA) is well recognized by its repeated episodes of upper airway obstruction during sleep. These recurrent cessation of airflow are associated with transient episodes of hypoxia, hypercapnia, and increasing inspiratory effort against the obstructed upper airway. Severe OSA has multiorgan complications such as caridiovascular diseases, liver diseases, renal diseases and cerebral diseases. However, it has not been clarified whether these patients have dysfunction of chemical control of breathing or higher brain center. In the present study, we aimed to study the ventilatory responses to hypoxia and hypercapnia and the inspiratory effort sensation(IES) to added inspiratory resistive loading, and to study the effect of nasal continuous positive airway pressure(CPAP) on these parameters in patients with OSA.The ventilatory response to hypoxia was higher and the ventilatory response to hypercapnia was lower than normal response of our laboratory before nasal CPAP. After nasal CPAP, the ventilatory response to hypoxia significantly decreased, whereas the ventilatory responses to hypercapnia significantly increased. IES to inspiratory resistive loading was lower in patients with OSA than in control subjects. After nasal CPAP, the IES increased to normal level.The results suggest that patients with OSA have the abnormal ventilatory responses to hypoxia, hypercapnia and IES response to added inspiratory loading during the daytime, and that nasal CPAP treatment can improve these responses in OSA. The altered chemosensitivity and lowered function of higher brain center may affect the severity of OSA.

阻塞性睡眠呼吸暂停（OSA）是众所周知的，其反复发作的上呼吸道阻塞在睡眠期间。这些反复出现的气流停止与短暂的缺氧、高碳酸血症和增加对阻塞的上气道的吸气努力有关。严重的阻塞性睡眠呼吸暂停可引起心血管疾病、肝脏疾病、肾脏疾病和脑部疾病等多器官并发症。但这些患者是否存在呼吸或高级脑中枢的化学控制功能障碍尚未明确。本研究旨在观察OSA患者对低氧和高碳酸血症的缓解反应以及对增加吸气阻力负荷的吸气努力感觉（IES），并研究经鼻持续气道正压通气（CPAP）对这些指标的影响。经鼻CPAP治疗后，对低氧的呼吸反应明显减弱，而对高碳酸血症的呼吸反应明显增强。OSA患者对吸气阻力负荷的IES低于对照组。结果提示，OSA患者存在对低氧、高碳酸血症的异常呼吸反应和对增加吸气负荷的异常呼吸反应，经鼻CPAP治疗可改善OSA患者的这些反应。药物敏感性的改变和高级脑中枢功能的降低可能影响OSA的严重程度。