Qiu Zhi-hui, Li Rui-fa, Zahng Dong, Luo Yuan-ming
State Key Laboratory of Respiratory Diseases (Guangzhou Medical University), First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Zhonghua Yi Xue Za Zhi. 2009 Nov 3;89(40):2818-21.
To evaluate the variability of neural respiratory drive in patients with obstructive sleep apnea (OSA) and the effect of continuous positive airway pressure (CPAP) upon neural respiratory drive.
We recorded diaphragm electromyogram (EMGdi) with multi-pair esophageal electrodes and its variability during wakefulness, sleep and treatment with CPAP in 13 patients with moderate to severe OSA diagnosed by an overnight full polysomnography (OSA group). Six normal subjects (control group) were also studied.
Coefficient of variation of EMGdi (CV-EMGdi) during wakefulness (15.4% +/- 3.8%) was similar to that during sleep (17.3% +/- 5.2, P > 0.05) in the control group. The CV-EMGdi during wakefulness, sleep, sleep apnea events and treatment with CPAP in OSA group was 14.7% +/- 1.9%, 40.7% +/- 12.0%, 29.1% +/- 7.5% and 15.4% +/- 4.6% respectively, CV-EMGdi during sleep or sleep apnea events was larger than that during wakefulness (P < 0.01). However, there was no difference in the CV-EMGdi during wakefulness and during treatment with CPAP (P > 0.05).
The variability of neural respiratory drive in patients with OSA is higher than that in normal subjects, and CPAP can reduce the variability of neural respiratory drive in patients with OSA.
评估阻塞性睡眠呼吸暂停（OSA）患者神经呼吸驱动的变异性以及持续气道正压通气（CPAP）对神经呼吸驱动的影响。
我们使用多对食管电极记录了13例经整夜全多导睡眠图诊断为中度至重度OSA患者（OSA组）在清醒、睡眠及CPAP治疗期间的膈肌肌电图（EMGdi）及其变异性。还对6名正常受试者（对照组）进行了研究。
对照组中，清醒时EMGdi的变异系数（CV-EMGdi）（15.4%±3.8%）与睡眠时（17.3%±5.2，P>0.05）相似。OSA组在清醒、睡眠、睡眠呼吸暂停事件及CPAP治疗期间的CV-EMGdi分别为14.7%±1.9%、40.7%±12.0%、29.1%±7.5%和15.4%±4.6%，睡眠或睡眠呼吸暂停事件期间的CV-EMGdi大于清醒时（P<0.01）。然而，清醒时与CPAP治疗期间的CV-EMGdi无差异（P>0.05）。
OSA患者神经呼吸驱动的变异性高于正常受试者，CPAP可降低OSA患者神经呼吸驱动的变异性。
