呼吸暂停婴儿的化学感受器反应延迟。
Delayed chemoreceptor responses in infants with apnoea.
作者信息
Katz-Salamon M
机构信息
Dept for Women's and Child Health, Karolinska Institute, Elevhemmet H1O2, S-171 76 Stockholm, Sweden.
出版信息
Arch Dis Child. 2004 Mar;89(3):261-6. doi: 10.1136/adc.2003.030957.
AIMS
To test the hypothesis that apnoea of infancy (AOI) is due to a deficit in chemoreception.
METHODS
Tests were performed on 112 infants: 43 healthy control infants, 28 infants with periodic breathing or central apnoea (PBCA), and 41 infants with obstructive apnoea (OA) on overnight polysomnography. Chemoreceptor responses to hypercapnia (4% and 6% CO2 in air) for 6-8 minutes and hyperoxia (100% O2) for 60 seconds were expressed in terms of response strength and reaction time. Age at birth (gestational week 37-41) and age at test (2-34 postnatal weeks) were comparable across groups (median, min-max value). A total of 70 CO2 and 71 O2 tests were analysed.
RESULTS
The strongest and fastest CO2 responders were control infants: their median increase in ventilation was 291%/kPaCO2 and their reaction time 16 breaths. In infants with PBCA and OA, the increase in ventilation was 41% and 130%/kPaCO2, and reaction time 64 and 54 breaths, respectively. There was a significant negative correlation between CO2 response strength and response time. In response to hyperoxia there was a comparable decrease in ventilation in all infants (12-20%), but a significantly longer response time in infants with apnoea (20 v 12 breaths). There was no correlation between the response strength and response time to O2 and CO2.
CONCLUSION
An inappropriate central control of respiration is an important mechanism in the pathogenesis of apnoea of infancy.
目的
验证婴儿呼吸暂停（AOI）是由于化学感受缺陷这一假说。
方法
对112名婴儿进行测试：43名健康对照婴儿，28名患有周期性呼吸或中枢性呼吸暂停（PBCA）的婴儿，以及41名经夜间多导睡眠图检查患有阻塞性呼吸暂停（OA）的婴儿。化学感受器对高碳酸血症（空气中4%和6%的二氧化碳）持续6 - 8分钟以及对高氧（100%氧气）持续60秒的反应通过反应强度和反应时间来表示。各组间出生时年龄（孕37 - 41周）和测试时年龄（出生后2 - 34周）具有可比性（中位数，最小值 - 最大值）。共分析了70次二氧化碳和71次氧气测试。
结果
对二氧化碳反应最强且最快的是对照婴儿：他们通气量的中位数增加为291%/kPaCO₂，反应时间为16次呼吸。患有PBCA和OA的婴儿，通气量增加分别为41%和130%/kPaCO₂，反应时间分别为64次和54次呼吸。二氧化碳反应强度与反应时间之间存在显著负相关。在对高氧的反应中，所有婴儿的通气量均有类似程度的下降（12 - 20%），但呼吸暂停婴儿的反应时间明显更长（20次呼吸对12次呼吸）。对氧气和二氧化碳的反应强度与反应时间之间无相关性。
结论
呼吸中枢控制不当是婴儿呼吸暂停发病机制中的一个重要机制。
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