Valipour A, McGown A D, Makker H, O'Sullivan C, Spiro S G
Dept of Thoracic Medicine, University College London Hospitals, UK.
Eur Respir J. 2002 Aug;20(2):444-50. doi: 10.1183/09031936.02.00265702.
Measurement of cerebral tissue saturation during obstructive sleep apnoea (OSA) may provide additional information to conventional peripheral oxygen saturation. Thirteen subjects with OSA (mean apnoea/hypopnoea index 65.7+/-27.9) were monitored using full polysomnography and monitoring of near-infrared cerebral tissue oxygenation index (TOI). One-thousand and thirty-six apnoeas and hypopnoeas were analysed, in terms of duration, sleep stage, arterial oxygen saturation (Sa,O2) dip, minimum Sa,O2, TOI dip and minimum TOI. Cerebral TOI is a measure of cerebral tissue saturation of haemoglobin with oxygen, calculated using near-infrared spatially resolved spectroscopy, which has been shown to have a high specificity for intracranial changes. Decreases in cerebral oxygenation were observed during apnoeas and hypopnoeas. Baseline TOI ranged from 50.1-73.0% and mean apnoea/hypopnoea related TOI dips ranged from 1.43-6.85%. Mean Sa,O2 dips varied from 3.8-21.7%. In regression analysis, factors significantly predicting the magnitude of the TOI dip were Sa,O2 dip, minimum Sa,O2, apnoea duration and rapid eye movement sleep stage. The effect of apnoea duration and sleep stage remained significant after Sa,O2 was included in the regression equation. Near-infrared spectroscopy provides a noninvasive technique for monitoring cerebral tissue saturation during obstructive sleep apnoea.
在阻塞性睡眠呼吸暂停(OSA)期间测量脑组织饱和度可能会为传统的外周血氧饱和度提供额外信息。使用全夜多导睡眠图和近红外脑组织氧合指数(TOI)监测对13名患有OSA的受试者(平均呼吸暂停/低通气指数为65.7±27.9)进行了监测。分析了1036次呼吸暂停和低通气的持续时间、睡眠阶段、动脉血氧饱和度(Sa,O2)下降、最低Sa,O2、TOI下降和最低TOI。脑组织TOI是通过近红外空间分辨光谱法计算得出的血红蛋白脑组织氧饱和度的一种测量方法,已证明其对颅内变化具有高特异性。在呼吸暂停和低通气期间观察到脑氧合下降。基线TOI范围为50.1 - 73.0%,平均呼吸暂停/低通气相关的TOI下降范围为1.43 - 6.85%。平均Sa,O2下降范围为3.8 - 21.7%。在回归分析中,显著预测TOI下降幅度的因素为Sa,O2下降、最低Sa,O2、呼吸暂停持续时间和快速眼动睡眠阶段。在回归方程中纳入Sa,O2后,呼吸暂停持续时间和睡眠阶段的影响仍然显著。近红外光谱法为阻塞性睡眠呼吸暂停期间监测脑组织饱和度提供了一种非侵入性技术。