Takasugi T, Ishihara T, Kawamura J, Sasaki K, Toyoda T, Oosumi M, Aoyagi T, Kawashiro T
National Higashi-Saitama Hospital, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1995 Aug;33(8):821-8.
Respiratory disorders during sleep were studied in 42 patients with Duchenne muscular dystrophy (DMD) (mean age 18.4 years). Chest and abdominal movement, nasal airflow, snoring sounds, eye movement, and oxygen saturation were monitored during sleep. Three patterns of disorders were found: obstructive apnea, central apnea, and paradoxical respiration without upper airway obstruction (non-obstructive paradoxical respiration). Of these three patterns, obstructive apnea was the most common. Hypertrophy of the tongue and collapsibility of the upper airway seemed to be responsible for the obstructive apnea in these patients. The relationships between PaCO2 while breathing room air and the various indices of respiratory disorders were studied. The index of central apnea differed significantly between patients in whom PaCO2 was less than 50 Torr (early disease, n = 22) and those in whom PaCO2 was greater than or equal to 50 Torr (advanced disease, n = 20), but the indices of obstructive apnea and non-obstructive paradoxical respiration did not differ between those two groups. In conclusion, sleep disorders were common in patients with DMD, and the most common was obstructive apnea. In the patients with advanced DMD, blood gas analysis showed hypercapnia, and the index of central sleep apnea was high, probably because of respiratory muscle weakness or abnormalities in the respiratory center.
对42例杜氏肌营养不良症（DMD）患者（平均年龄18.4岁）的睡眠呼吸障碍进行了研究。在睡眠期间监测胸部和腹部运动、鼻腔气流、打鼾声、眼球运动和血氧饱和度。发现了三种障碍模式：阻塞性呼吸暂停、中枢性呼吸暂停和无气道阻塞的矛盾呼吸（非阻塞性矛盾呼吸）。在这三种模式中，阻塞性呼吸暂停最为常见。舌头肥大和上气道可塌陷性似乎是这些患者阻塞性呼吸暂停的原因。研究了呼吸室内空气时的PaCO2与各种呼吸障碍指标之间的关系。PaCO2小于50 Torr的患者（早期疾病，n = 22）和PaCO2大于或等于50 Torr的患者（晚期疾病，n = 20）的中枢性呼吸暂停指标有显著差异，但两组之间的阻塞性呼吸暂停和非阻塞性矛盾呼吸指标没有差异。总之，睡眠障碍在DMD患者中很常见，最常见的是阻塞性呼吸暂停。在晚期DMD患者中，血气分析显示高碳酸血症，中枢性睡眠呼吸暂停指标较高，可能原因是呼吸肌无力或呼吸中枢异常。
