驱动与压力对抗 阻塞性睡眠呼吸暂停中天花活动的贡献
Laura K Gell1, Daniel Vena1, Kevin Grace2
1Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; and.
Annals of the American Thoracic Society
|July 6, 2023
概括
在阻塞性睡眠呼吸暂停 (OSA) 中,丧失基尼格洛索斯活动与呼吸器驱动力减少有关. 患者,其 genioglossus 活动轨迹更紧密地驱动,经历更大的下降,表明潜在的治疗目标.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 喉扩张肌肉不活动在阻塞性睡眠呼吸暂停 (OSA) 事件中至关重要.
- 睡眠期间的 Genioglossus 肌肉激活依赖于清醒刺激,负压和通风驱动反.
- 在阻塞性事件期间,驱动和压力在神经光活动中的不同作用尚未完全理解.
研究的目的:
- 调查是否减少的呼吸机驱动解释了OSA.在阻塞事件期间的 genioglossus 肌肉不活动.
- 量化通风机驱动和负压对 genioglossus 活动的相对贡献.
主要方法:
- 研究了42名OSA患者,测量了在自发呼吸事件期间的光肌电图 (EMGgg),通风驱动和食道压力.
- 利用集合平均和多变量回归来分析这些变量的时间进程.
主要成果:
- 阴活动 (EMGgg) 变化得到了下降的驱动力和上升的负压力 (R=0.91) 的充分解释.
- EMGgg与驱动力 (2.9倍) 比压力更强烈地相关.
- 患者的反应是异质的,约50%的反应是驱动主导的,约25%是压力主导的.
结论:
- 在OSA事件中,降低神经光活动与呼吸器驱动力下降有显著的关联.
- 在具有驱动主导反应的患者中,基因光活动的下降更大.
- 治疗策略增强 genioglossus 对压力超过驱动的反应可能是有益的.
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