适应性伺服通风治疗患者的呼吸中心功能:病因和结果
Isabel Martinez-Gonzalez Posada1, Ramón Fernández Álvarez2, Andres Ortiz Reyes1
1Respiratory Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.
概括
适应性伺服通风 (ASV) 在中枢睡眠呼吸暂停 (CSA) 患者中使呼吸中心功能正常化. 这种治疗改善了呼吸系统对高头的反应,这表明ASV可以区分CSA表型和指导治疗.
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:
- 中央睡眠呼吸暂停 (CSA) 涉及呼吸控制的不稳定性和过度通风.
- 适应性伺服通风 (ASV) 是CSA的主要治疗方法.
- 在CSA患者中,呼吸中心的高响应性是假设的.
研究的目的:
- 在CSA患者中测量呼吸道对高头的反应.
- 评估ASV治疗是否能使呼吸中心功能正常化.
- 调查呼吸器反应和ASV结果之间的关系.
主要方法:
- 在46名用ASV治疗的CSA患者中进行了重复测量的前性研究.
- 在ASV≥6个月之前和之后通过p0.1/pEtCO2评估呼吸系统对高头的反应.
- 统计分析包括皮尔森相关性和t测试;参考p0.1/pEtCO2值为0.43cmH2O/mmHg.
主要成果:
- 最初的p0.1/pEtCO2为0.48cmH2O/mmHg,明显高于参考值 (P=.02).
- 在ASV之后,63%的人将p0.1/pEtCO2正常化至0.37cmH2O/mmHg (P=.015与初始相比).
- 与阿片类药物使用次要的CSA显示较低的p0.1/pEtCO2 (0.27cmH2O/mmHg,P=.021).
结论:
- 在CSA患者中,呼吸系统对高头的反应可以通过ASV治疗来正常化.
- 治疗ASV可能有助于区分CSA表型.
- 测量呼吸器反应可以为CSA的治疗决策提供信息.
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