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计算分析悬雍垂扑动对睡眠呼吸暂停时咽壁塌陷的空气动力学影响。

Computational analysis of a flapping uvula on aerodynamics and pharyngeal wall collapsibility in sleep apnea.

机构信息

Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA.

Department of Biomedical Engineering, California Baptist University, Riverside, CA, USA.

出版信息

J Biomech. 2019 Sep 20;94:88-98. doi: 10.1016/j.jbiomech.2019.07.014. Epub 2019 Jul 25.

Abstract

Studying the airflows and the resultant aerodynamic pressure/force in the pharyngeal airway is critical for understanding the pathophysiology of snoring and sleep apnea. In this work, an experiment-driven computational study was conducted to examine the aerodynamics in human pharyngeal airway. An anatomically accurate pharynx model associated with different uvula kinematics was reconstructed from human magnetic resonance image (MRI) and high-speed photography. An immersed-boundary-method (IBM)-based direct numerical simulation (DNS) flow solver was adopted to simulate the corresponding unsteady flows in all their complexity. Analyses were performed on vortex dynamics and pressure fluctuations in the pharyngeal airway and force oscillations on the pharyngeal wall under the influence of varying airway obstructions, uvula flapping mode, and uvula flapping frequencies. It was found the vortex formation, aerodynamic pressure, and pharyngeal wall force were significantly affected by the width of the pharyngeal airway. By contrast, the influences from the uvula flapping mode were insignificant when other parameters were similar. Fast Fourier transformation (FFT) and continuous wavelet transform (CWT) analysis of the pressure time history revealed the existence of higher order harmonics of base frequency with significant pressure amplitudes and energy intensities. It was also found the airway pressure and pharyngeal wall force oscillate more dramatically at higher uvula flapping frequencies, which tends to promote the collapse of pharyngeal wall and initiates sleep apnea.

摘要

研究咽气道中的气流和由此产生的空气动力压力对于理解打鼾和睡眠呼吸暂停的病理生理学至关重要。在这项工作中,进行了一项基于实验的计算研究,以检查人类咽气道中的空气动力学。从人体磁共振成像 (MRI) 和高速摄影中重建了与不同悬雍垂运动相关的解剖学准确的咽模型。采用基于浸入边界法 (IBM) 的直接数值模拟 (DNS) 流求解器来模拟所有复杂性的相应非定常流。在气道阻塞、悬雍垂拍打模式和悬雍垂拍打频率变化的影响下,对咽气道中的涡动力学和压力波动以及咽壁上的力振荡进行了分析。结果发现,涡的形成、空气动力压力和咽壁力受到咽气道宽度的显著影响。相比之下,当其他参数相似时,悬雍垂拍打模式的影响可以忽略不计。对压力时间历史的快速傅里叶变换 (FFT) 和连续小波变换 (CWT) 分析揭示了存在具有显著压力幅值和能量强度的基频的更高阶谐波。还发现,悬雍垂拍打频率较高时,气道压力和咽壁力的振荡更为剧烈,这往往会导致咽壁塌陷并引发睡眠呼吸暂停。

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