Toronto General Hospital, University Health Network, Toronto, Canada; Departments of Physiology, Anaesthesia & Medicine, University of Toronto, Toronto, Canada.
Respir Physiol Neurobiol. 2014 Jan 1;190:47-53. doi: 10.1016/j.resp.2013.09.003. Epub 2013 Sep 17.
Both obstructive sleep apnoea (OSA) and impaired cerebrovascular reactivity (CVR) are associated with an increased risk of stroke. We therefore hypothesized that CVR would be decreased in OSA patients. Since OSA is associated with altered endothelial function and this dysfunction may in turn lead to impaired CVR, we further hypothesized that a CVR decrease could be the responsible mechanism for stroke. Middle cerebral artery blood flow velocity (MCAv) and mean arterial blood pressure (MAP) responses to hypercapnia were measured to determine cerebrovascular conductance (MCAv/MAP). Overnight changes in conductance CVR were assessed in treatment naïve, otherwise healthy OSA (n=13) and non-OSA (n=9) subjects at two isoxic tensions (150 and 50mmHg). We found no significant overnight changes in CVR for either group. There were no differences in CVR between OSA and non-OSA subjects for either isoxic tension, although CVR was increased in hypoxia.
阻塞性睡眠呼吸暂停(OSA)和脑血流反应性(CVR)受损均与中风风险增加相关。因此,我们假设 OSA 患者的 CVR 会降低。由于 OSA 与内皮功能改变有关,而这种功能障碍可能反过来导致 CVR 受损,我们进一步假设 CVR 降低可能是中风的原因。通过测量大脑中动脉血流速度(MCAv)和平均动脉血压(MAP)对高碳酸血症的反应来确定脑血管导纳(MCAv/MAP)。在两个等氧张力(150 和 50mmHg)下,我们评估了未经治疗的、无其他健康问题的 OSA(n=13)和非 OSA(n=9)患者的导纳 CVR 的夜间变化。我们发现两组的 CVR 均无明显的夜间变化。在两种等氧张力下,OSA 和非 OSA 患者之间的 CVR 没有差异,尽管在缺氧时 CVR 增加。