Sun Qi-Jian, Berkowitz Robert G, Pilowsky Paul M
Hypertension and Stroke Research Laboratories, Department of Physiology, University of Sydney, Sydney, NSW 2006, Australia.
Respir Physiol Neurobiol. 2005 Apr 15;146(2-3):155-63. doi: 10.1016/j.resp.2004.12.006.
Central apnea is common in the premature newborn. To explain the upper airway findings in different clinical conditions characterized by central apnea, we made single unit recordings from laryngeal motoneurons during normal and hyperventilation. Posterior cricoarytenoid (n = 4) and cricothyroid (n = 4) motoneurons displayed an inspiratory pattern during normal ventilation and remained synchronous with phrenic nerve discharge (PND) during hyperventilation. Laryngeal constrictor motoneurons (LCon) displayed a post-inspiratory pattern during normal ventilation, but lost phasic activity during early hyperventilation (the period after the onset of hyperventilation but before cessation of PND; n = 12). There was a nearly linear relationship between the post-inspiratory activity and strength of PND. Six LCon motoneurons remained silent throughout hyperventilation, while the other six developed a tonic activity during cessation of PND. Further analysis suggested that the silent and tonic LCon motoneurons are likely to share a similar mechanism in their post-inspiratory pattern generation, but differ from each other in their responses to CO2 inputs. In addition, strong inhibition of the LCon tonic activity by the early return of PND could be an important factor in recovery following a period of apnea. Failure of this inspiratory inhibition to occur might explain certain clinical situations, where obstructive apnea supervenes following a period of central apnea.
中枢性呼吸暂停在早产新生儿中很常见。为了解释以中枢性呼吸暂停为特征的不同临床情况下上呼吸道的表现,我们在正常通气和过度通气期间对喉运动神经元进行了单单位记录。后环杓肌(n = 4)和环甲肌(n = 4)运动神经元在正常通气时呈现吸气模式,在过度通气时与膈神经放电(PND)保持同步。喉括约肌运动神经元(LCon)在正常通气时呈现吸气后模式,但在早期过度通气(过度通气开始后但PND停止前的时间段;n = 12)期间失去了相位活动。吸气后活动与PND强度之间存在近乎线性的关系。六个LCon运动神经元在整个过度通气过程中保持沉默,而另外六个在PND停止期间出现了紧张性活动。进一步分析表明,沉默的和紧张性的LCon运动神经元在其吸气后模式产生中可能具有相似的机制,但在对二氧化碳输入的反应上彼此不同。此外,PND早期恢复对LCon紧张性活动的强烈抑制可能是呼吸暂停一段时间后恢复的一个重要因素。这种吸气抑制未能发生可能解释了某些临床情况,即中枢性呼吸暂停一段时间后会出现阻塞性呼吸暂停。