Narkiewicz K, Kato M, Phillips B G, Pesek C A, Davison D E, Somers V K
Department of Internal Medicine, University of Iowa, Iowa City, USA.
Circulation. 1999 Dec 7;100(23):2332-5. doi: 10.1161/01.cir.100.23.2332.
Patients with obstructive sleep apnea (OSA) have high levels of muscle sympathetic nerve activity (MSNA). We tested the hypothesis that long-term continuous positive airway pressure (CPAP) treatment will decrease MSNA in OSA patients.
We measured blood pressure, heart rate, and MSNA in 11 normotensive, otherwise healthy patients with OSA who were treated with CPAP. The measurements were obtained at baseline and after 1 month, 6 months, and 1 year of CPAP treatment. These measurements were compared with those recorded in 9 otherwise healthy OSA patients who were not treated with CPAP for 1 year. In both untreated and treated patients, blood pressure and heart rate did not change over time. MSNA was similar during repeated measurements in the untreated group. By contrast, MSNA decreased significantly over time in patients treated with CPAP. This decrease was evident after both 6 months and 1 year of CPAP treatment (P=0.02 for both).
CPAP treatment decreases muscle sympathetic traffic in patients with OSA. This effect of CPAP is evident only after an extended duration of therapy.
阻塞性睡眠呼吸暂停（OSA）患者的肌肉交感神经活动（MSNA）水平较高。我们检验了长期持续气道正压通气（CPAP）治疗会降低OSA患者MSNA这一假设。
我们测量了11名血压正常、其他方面健康的接受CPAP治疗的OSA患者的血压、心率和MSNA。这些测量值在基线时以及CPAP治疗1个月、6个月和1年后获取。将这些测量值与9名其他方面健康但未接受CPAP治疗1年的OSA患者所记录的值进行比较。在未治疗和治疗的患者中，血压和心率均未随时间变化。在未治疗组中，重复测量期间MSNA相似。相比之下，接受CPAP治疗的患者MSNA随时间显著降低。这种降低在CPAP治疗6个月和1年后均很明显（两者P均 = 0.02）。
CPAP治疗可降低OSA患者的肌肉交感神经活动。CPAP的这种作用仅在延长治疗时间后才明显。
