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经鼻持续气道正压通气对阻塞性睡眠呼吸暂停患者清醒时低氧和高碳酸血症通气反应的影响。

Effects of nasal continuous positive airway pressure on awake ventilatory responses to hypoxia and hypercapnia in patients with obstructive sleep apnea.

作者信息

Tun Y, Hida W, Okabe S, Kikuchi Y, Kurosawa H, Tabata M, Shirato K

机构信息

The First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.

出版信息

Tohoku J Exp Med. 2000 Feb;190(2):157-68. doi: 10.1620/tjem.190.157.

Abstract

This study was aimed to examine the short- and long-term effects of nasal continuous positive airway pressure (CPAP) on the chemosensitivity to hypoxia and hypercapnia in the patients with obstructive sleep apnea (OSA). Awake ventilatory responses to hypoxia and hypercapnia were examined in 28 patients (3 female) with moderate to severe OSA. All these tests were examined before and after 2 weeks of nasal CPAP. In 10 patients these tests were repeated after 3-6 months of nasal CPAP. All were also tested for spirometry and arterial blood gas analysis. Patients were middle-aged (48.9 +/- 9.9 years) and their mean apnea-hypopnea index was 58.3 +/- 20.4/hour. After 2 week of nasal CPAP, PaO2 significantly increased (77.7 +/- 11.8 vs. 84.6 +/- 9.8 mmHg) and PaCO2 significantly decreased (44.9 +/- 3.8 vs. 42.3 +/- 3.7 mmHg). The ventilatory response to hypoxia significantly decreased (0.80 +/- 0.51 vs. 0.61 +/- 0.51 liter/min/%) whereas the ventilatory response to hypercapnia significantly increased after 2 weeks (1.47 +/- 0.73 vs. 1.80 +/- 0.76 liter/min/mmHg). Similar findings were also observed after 3-6 months of nasal CPAP in 10 OSA patients. Nasal CPAP treatment can alter the ventilatory responses in patients with OSA.

摘要

本研究旨在探讨经鼻持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停(OSA)患者低氧和高碳酸血症化学敏感性的短期和长期影响。对28例(3例女性)中重度OSA患者进行了清醒状态下对低氧和高碳酸血症的通气反应检查。所有这些检查均在经鼻CPAP治疗2周前后进行。在10例患者中,经鼻CPAP治疗3 - 6个月后重复进行这些检查。所有患者还进行了肺量计检查和动脉血气分析。患者为中年(48.9±9.9岁),平均呼吸暂停低通气指数为58.3±20.4次/小时。经鼻CPAP治疗2周后,动脉血氧分压(PaO₂)显著升高(77.7±11.8 vs. 84.6±9.8 mmHg),动脉血二氧化碳分压(PaCO₂)显著降低(44.9±3.8 vs. 42.3±3.7 mmHg)。对低氧的通气反应显著降低(0.80±0.51 vs. 0.61±0.51升/分钟/%),而对高碳酸血症的通气反应在2周后显著增加(1.47±0.73 vs. 1.80±0.76升/分钟/mmHg)。在10例OSA患者经鼻CPAP治疗3 - 6个月后也观察到了类似结果。经鼻CPAP治疗可改变OSA患者的通气反应。

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