Jennum P, Børgesen S E
Department of Neurophysiology, Glostrup Hospital, Denmark.
Chest. 1989 Feb;95(2):279-83. doi: 10.1378/chest.95.2.279.
In order to describe variation in AP and ICP during OSA, six patients with severe OSA were examined, with determination of ICP, AP, CVP, respiration, tcPO2, tcPCO2, and nocturnal sleep polygraphy. During apnea, elevations of AP and ICP were observed, related to the apneic episodes. The elevations in pressure were only observed in relation to apneic episodes. While awake, none of the patients showed pressure elevations. There were highly significant correlations between duration of apnea and variation in AP and ICP and between variations in AP and ICP. Values for ICP while awake were above normal (greater than 15 mm Hg; intracranial hypertension) in four of six patients. Morning ICP was higher than evening ICP. Systolic, mean, and diastolic ICP and AP increased during sleep above awake values. The ICP increased during NREM stages 1 to 4, and the highest values were observed during REM sleep. Vascular response was not changed during REM sleep, and the higher ICP during REM could solely be explained by the longer apneas during REM sleep. The CPP decreased during apnea.
为了描述阻塞性睡眠呼吸暂停（OSA）期间动脉压（AP）和颅内压（ICP）的变化，对6例重度OSA患者进行了检查，测定了ICP、AP、中心静脉压（CVP）、呼吸、经皮血氧分压（tcPO2）、经皮二氧化碳分压（tcPCO2）以及夜间睡眠多导记录图。在呼吸暂停期间，观察到AP和ICP升高，这与呼吸暂停发作有关。压力升高仅在呼吸暂停发作时观察到。清醒时，所有患者均未出现压力升高。呼吸暂停持续时间与AP和ICP变化之间以及AP和ICP变化之间存在高度显著的相关性。6例患者中有4例清醒时的ICP值高于正常（大于15 mmHg；颅内高压）。早晨的ICP高于晚上的ICP。睡眠期间收缩压、平均压和舒张压的ICP和AP均高于清醒值。ICP在非快速眼动（NREM）睡眠1至4期升高，在快速眼动（REM）睡眠期间观察到最高值。REM睡眠期间血管反应未改变，REM睡眠期间较高的ICP仅可由REM睡眠期间较长的呼吸暂停来解释。呼吸暂停期间脑灌注压（CPP）降低。
