在用德克斯梅德托米丁镇静期间识别阻塞性睡眠呼吸暂停的病理生理特征
Chunbo Li1,2, Renqiang Ma1,2, Xingmei Wu1,2
1Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Journal of sleep research
|October 25, 2023
概括
德克斯梅德托米丁 (DEX) 镇静剂通过增加喉缩性,唤醒值和循环增长来加剧阻塞性睡眠呼吸暂停 (OSA) 的特征. 这种镇静剂对OSA患者的扩张肌肉功能没有影响.
科学领域:
- 睡眠医学 睡眠医学
- 麻醉学 麻醉学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 阻塞性睡眠呼吸暂停 (obstructive sleep apnea,OSA) 是一种常见的睡眠障碍,在睡眠期间重复出现上呼吸道崩的特征.
- 德克斯梅德托米丁 (DEX) 是一种在临床实践中使用的镇静剂,但其对OSA病理生理学的影响尚不清楚.
- 了解DEX的作用对于治疗正在接受镇静的OSA患者至关重要.
研究的目的:
- 研究DEX镇静对OSA关键病理生理特征的影响.
- 为了比较自然睡眠中的这些特征与DEX诱导的睡眠.
- 为了确定在DEX镇静下OSA严重性的预测因素.
主要方法:
- 一项涉及成年OSA患者的前性诊断试验的二次分析.
- 多睡眠学被用来评估喉缩性,扩张肌肉功能,唤醒值和自然和DEX诱导睡眠期间的循环增长.
- 进行了双变量和多变量线性回归分析,以将OSA特征与严重程度相关联.
主要成果:
- 与自然睡眠相比,DEX诱导的睡眠显著增加了喉折叠性,唤醒值和循环增长.
- 扩展肌肉功能和一般的PSG呼吸参数不受DEX镇静的影响.
- 喉缩性被确定为呼吸暂停-呼吸暂停指数最强的预测指标.
结论:
- 德克斯梅德托米丁镇静剂加剧了OSA患者的关键病理生理特征.
- 镇静剂增加了喉缩性和循环增长,同时提高了兴奋值.
- 尽管有这些变化,但DEX不会损害OSA患者的扩展肌肉功能.
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