Phillipson E A, Yasuma F, Kozar L F, England S J
Department of Medicine, University of Toronto, Ontario.
Prog Clin Biol Res. 1990;345:201-11; discussion 211-3.
The present findings in awake and sleeping dogs confirm the early observations in anesthetized cats (Bainton et al., 1978; Sears et al., 1982), and more recent studies in awake and sleeping humans (Takasaki et al., 1989), that suggest an asymmetry in pattern of respiratory motoneuron and muscle activation by central and peripheral chemoreceptor stimulation, with central chemoreceptor stimulation driving both inspiratory and expiratory mechanisms, and peripheral chemoreceptor stimulation driving inspiratory and inhibiting expiratory mechanisms. Because REM sleep inhibits the nondiaphragmatic muscles, which include the expiratory muscles, there is a reduction in CO2 response during this sleep stage. In contrast because the response to hypoxia is mediated predominantly by the diaphragm, which is not generally inhibited by REM sleep, there is less effect of REM sleep on the overall response to hypoxia. In addition to being of basic importance, these concepts may have important clinical implications.
目前对清醒和睡眠状态下犬类的研究结果证实了早期对麻醉猫（Bainton等人，1978年；Sears等人，1982年）以及近期对清醒和睡眠状态下人类（Takasaki等人，1989年）的观察结果，这些结果表明，中枢和外周化学感受器刺激引起的呼吸运动神经元和肌肉激活模式存在不对称性，中枢化学感受器刺激驱动吸气和呼气机制，外周化学感受器刺激驱动吸气并抑制呼气机制。由于快速眼动睡眠会抑制包括呼气肌在内的非膈肌，因此在这个睡眠阶段二氧化碳反应会降低。相比之下，由于对低氧的反应主要由膈肌介导，而膈肌通常不会被快速眼动睡眠抑制，所以快速眼动睡眠对整体低氧反应的影响较小。这些概念除了具有基本重要性外，可能还具有重要的临床意义。
