Foster Glen E, Hanly Patrick J, Ostrowski Michele, Poulin Marc J
Department of Physiology and Biophysics, Faculty of Medicine, University of Calgary, Alberta T2N 4N1, Canada.
Respir Physiol Neurobiol. 2009 Jan 1;165(1):73-81. doi: 10.1016/j.resp.2008.10.011. Epub 2008 Oct 19.
The purpose of this study was to assess whether the cerebrovascular response to hypercapnia is blunted in OSA patients and if this could alter the ventilatory response to hypercapnia before and after CPAP therapy. We measured the cerebrovascular, cardiovascular and ventilatory responses to hypercapnia in 8 patients with OSA (apnoea-hypopnoea index=101+/-10) before and after 4-6 weeks of CPAP therapy and in 10 control subjects who did not undergo CPAP therapy. The cerebrovascular and ventilatory responses to hypercapnia were not different between OSA and controls at baseline or follow-up. The cardiovascular response to hypercapnia was significantly increased in the OSA group by CPAP therapy (mean arterial pressure response: 1.30+/-0.16 vs. 2.04+/-0.36 mmHg Torr(-1); p=0.007). We conclude that in normocapnic, normotensive OSA patients without cardiovascular disease, the ventilatory, cerebrovascular, and cardiovascular responses to hypercapnia are normal, but the cardiovascular response to hypercapnia is heightened following 1 month of CPAP therapy.
本研究的目的是评估阻塞性睡眠呼吸暂停（OSA）患者对高碳酸血症的脑血管反应是否减弱，以及这是否会改变CPAP治疗前后对高碳酸血症的通气反应。我们测量了8例OSA患者（呼吸暂停低通气指数=101±10）在CPAP治疗4-6周前后以及10例未接受CPAP治疗的对照受试者对高碳酸血症的脑血管、心血管和通气反应。在基线或随访时，OSA患者与对照受试者对高碳酸血症的脑血管和通气反应并无差异。CPAP治疗使OSA组对高碳酸血症的心血管反应显著增加（平均动脉压反应：1.30±0.16 vs. 2.04±0.36 mmHg Torr⁻¹；p=0.007）。我们得出结论，在无心血管疾病的正常碳酸血症、血压正常的OSA患者中，对高碳酸血症的通气、脑血管和心血管反应正常，但在CPAP治疗1个月后，对高碳酸血症的心血管反应增强。
