慢性心力衰竭患者在清醒期间的振荡呼吸模式:临床含义和增强的外周化学敏感性作用
P Ponikowski1, S D Anker, T P Chua
1Cardiac Medicine, Imperial College, National Heart & Lung Institute, London, UK.
像切恩-斯托克斯呼吸 (CSR) 和周期性呼吸 (PB) 这样的振荡呼吸模式在慢性心力衰竭 (CHF) 中很常见. 这些模式表明预后不佳,可能与外围化学敏感性增加有关.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 睡眠医学 睡眠医学
背景情况:
- 在慢性心力衰竭 (CHF) 患者中,振荡式呼吸模式,包括切恩-斯托克斯呼吸 (CSR) 和周期性呼吸 (PB),很普遍.
- 这些呼吸异常通常在白天睡眠期间表现出来,并且与潜在的疾病有关.
研究的目的:
- 为了前性地研究临床特征,自主控制,预后和外周化学敏感性在CHF患者表现出循环呼吸模式中的作用.
- 为了确定调节外周化学敏感性是否会影响这些异常的呼吸模式.
主要方法:
- 呼吸的功率光谱分析被用来确定74名稳定的CHF患者的循环呼吸模式.
- 自主平衡通过心率变化和巴罗反射灵敏度来评估.
- 使用过渡性缺氧方法测量了周围化学敏感性,并评估了高氧和二代的影响.
主要成果:
- 周期性呼吸 (CSR或PB) 在66%的患者中被确定,与晚期心血管疾病症状,自主控制受损和外周化学敏感性增加相关.
- 在大多数被测试的患者中,过渡性过氧消除了振荡呼吸.
- 丁可丁的使用降低了化学敏感性和改善了呼吸模式,而循环呼吸独立地预测了2年生存率不佳.
结论:
- 在CHF中白天振荡呼吸是自主功能障碍的重要标志物,预示着预后不佳.
- 增强的外周化疗受体活性似乎有助于这些呼吸模式的发展.
- 针对外周化学敏感性提供了一个潜在的治疗策略,用于管理CHF患者的振荡呼吸.
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