Chiang C H, Tang Y C, Wang S E, Hwang J C
Dept of Medicine, Tri-Service General Hospital, National Defense, Medical, Center Taipei, Taiwan, Republic of China.
Eur Respir J. 1995 Apr;8(4):632-6.
Aminophylline is known to have respiratory stimulant properties, and it has been suggested that it may also be effective in sleep apnoea. However, its role in this disorder remains uncertain. Theoretically, increasing upper airway motoneural activity in order to maintain airway patency might alleviate obstructive sleep apnoea. On the other hand, increasing the respiratory drive may also prove beneficial in treating central sleep apnoea. In these studies, we attempted to determine the effect of aminophylline on neural activities of the upper airway and diaphragm. We administered intravenously either a low dose (4 mg.kg-1) or a high dose (16 mg.kg-1) of aminophylline to decerebrated, vagotomized and paralysed cats, and continuously recorded the phrenic hypoglossal and recurrent laryngeal nerve activities for 3 h. Results showed that a high dose of aminophylline induced a marked increase in phrenic nerve activity, but not hypoglossal or recurrent laryngeal nerve activity. In a group treated with a low dosage of aminophylline, a significant increase of activity was found in all three nerves. Furthermore, phrenic nerve activity increased more with a high dose than with a low dose. We confirmed that aminophylline has dose-dependent and selective effects on respiratory neural activity. A low dose acts on the upper airway and diaphragm, but a high dose induces a marked increase in central respiratory drive. According to our results, low dose aminophylline might be beneficial in obstructive sleep apnoea, whereas, a high or low dose might improve some cases of central sleep apnoea.
已知氨茶碱具有呼吸刺激特性,有人提出它可能对睡眠呼吸暂停也有效。然而,其在这种疾病中的作用仍不确定。从理论上讲,增加上呼吸道运动神经活动以维持气道通畅可能会减轻阻塞性睡眠呼吸暂停。另一方面,增加呼吸驱动力在治疗中枢性睡眠呼吸暂停中也可能被证明是有益的。在这些研究中,我们试图确定氨茶碱对上呼吸道和膈肌神经活动的影响。我们给去大脑、切断迷走神经并麻痹的猫静脉注射低剂量(4毫克/千克)或高剂量(16毫克/千克)的氨茶碱,并连续记录膈神经、舌下神经和喉返神经活动3小时。结果表明,高剂量的氨茶碱可引起膈神经活动显著增加,但舌下神经或喉返神经活动无明显变化。在低剂量氨茶碱治疗组中,所有三条神经的活动均有显著增加。此外,高剂量组膈神经活动的增加幅度大于低剂量组。我们证实氨茶碱对呼吸神经活动具有剂量依赖性和选择性作用。低剂量作用于上呼吸道和膈肌,而高剂量可引起中枢呼吸驱动力显著增加。根据我们的研究结果,低剂量氨茶碱可能对阻塞性睡眠呼吸暂停有益,而高剂量或低剂量可能改善某些中枢性睡眠呼吸暂停病例。