Tang Jing, Lu Yi-rong, Luo Yuan-ming
State Key Laboratory of Respiratory Disease, Guangzhou, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2009 Oct;32(10):732-5.
Measurement of esophageal pressure is considered to be the gold standard for assessing respiratory effort and neural respiratory drive but this requires placement of an esophageal catheter. We hypothesized that neural drive could be reflected by the diaphragm EMG recorded from chest wall surface electrodes.
We simultaneously recorded esophageal pressure and the chest wall diaphragm EMG in 11 patients with suspected obstructive sleep apnea/hypopnea syndrome during full night polysomnography. We also recorded the diaphragm EMG from esophageal electrode in 5 of the 11 subjects.
Diaphragm EMG could be satisfactorily recorded from 9 of the 11 subjects. The root mean square of the chest wall diaphragm EMG increased gradually during the obstructive sleep apnea events and reached a maximal value at arousal. Similarly, the esophageal pressure increased gradually over the obstructive sleep apnea events and reached a maximal value at the end of apnea. There was a relation between the RMS of the diaphragm EMG recorded from the chest wall surface electrodes and esophageal pressure (r = 0.66) and the diaphragm EMG (r = 0.72) recorded from esophageal electrode during obstructive event.
The diaphragm EMG could be recorded from the chest wall surface electrodes in most subjects and can be used to demonstrate the presence of respiratory effort during apnoea/hypopnea events.
食管压力测量被认为是评估呼吸努力和神经呼吸驱动的金标准，但这需要放置食管导管。我们假设神经驱动可以通过胸壁表面电极记录的膈肌肌电图来反映。
我们在11例疑似阻塞性睡眠呼吸暂停/低通气综合征患者的全夜多导睡眠图检查期间，同时记录食管压力和胸壁膈肌肌电图。我们还在11名受试者中的5名中通过食管电极记录膈肌肌电图。
11名受试者中有9名能够满意地记录到膈肌肌电图。在阻塞性睡眠呼吸暂停事件期间，胸壁膈肌肌电图的均方根逐渐增加，并在觉醒时达到最大值。同样，食管压力在阻塞性睡眠呼吸暂停事件中逐渐增加，并在呼吸暂停结束时达到最大值。在阻塞事件期间，从胸壁表面电极记录的膈肌肌电图的均方根与食管压力之间存在相关性（r = 0.66），与从食管电极记录的膈肌肌电图之间也存在相关性（r = 0.72）。
大多数受试者可以通过胸壁表面电极记录到膈肌肌电图，并且可用于证明呼吸暂停/低通气事件期间呼吸努力的存在。
