Remsburg S, Launois S H, Weiss J W
Charles A. Dana Institute and the Harvard-Thorndike Laboratory of Beth Israel Deaconess Medical Center, Boston 02215, Massachusetts, USA.
J Appl Physiol (1985). 1999 Sep;87(3):1148-53. doi: 10.1152/jappl.1999.87.3.1148.
Patients with obstructive sleep apnea (OSA) have been reported to have an augmented pressor response to hypoxic rebreathing. To assess the contribution of the peripheral vasculature to this hemodynamic response, we measured heart rate, mean arterial pressure (MAP), and forearm blood flow by venous occlusion plethysmography in 13 patients with OSA and in 6 nonapneic control subjects at arterial oxygen saturations (Sa(O(2))) of 90, 85, and 80% during progressive isocapnic hypoxia. Measurements were also performed during recovery from 5 min of forearm ischemia induced with cuff occlusion. MAP increased similarly in both groups during hypoxia (mean increase at 80% Sa(O(2)): OSA patients, 9 +/- 11 mmHg; controls, 12 +/- 7 mmHg). Forearm vascular resistance, calculated from forearm blood flow and MAP, decreased in controls (mean change -37 +/- 19% at Sa(O(2)) 80%) but not in patients (mean change -4 +/- 16% at 80% Sa(O(2))). Both groups decreased forearm vascular resistance similarly after forearm ischemia (maximum change from baseline -85%). We conclude that OSA patients have an abnormal peripheral vascular response to isocapnic hypoxia.
据报道，阻塞性睡眠呼吸暂停（OSA）患者对低氧再呼吸的升压反应增强。为了评估外周血管系统对这种血流动力学反应的贡献，我们在13例OSA患者和6例无呼吸的对照受试者中，通过静脉闭塞体积描记法测量了心率、平均动脉压（MAP）和前臂血流量，这些测量是在进行性等容低氧期间，动脉血氧饱和度（Sa（O₂））分别为90%、85%和80%时进行的。在前臂袖带闭塞诱导5分钟缺血恢复期间也进行了测量。低氧期间两组的MAP升高相似（在Sa（O₂）80%时的平均升高：OSA患者为9±11 mmHg；对照组为12±7 mmHg）。根据前臂血流量和MAP计算的前臂血管阻力，在对照组中降低（在Sa（O₂）80%时平均变化-37±19%），但在患者中未降低（在Sa（O₂）80%时平均变化-4±16%）。两组在前臂缺血后前臂血管阻力降低相似（相对于基线的最大变化为-85%）。我们得出结论，OSA患者对等容低氧的外周血管反应异常。
