Oyama T, Okuda Y, Oyama H, Onuma M, Takasugi K
Center for Rheumatic Diseases, Dohgo Spa Hospital, Matsuyama-city.
Ryumachi. 1995 Feb;35(1):3-8.
All-night polysomnographic studies were performed on ten patients (all female) with rheumatoid arthritis complicated with temporomandibular joint destruction and cervical lesions. The mean age of these subjects was 67.5 yrs, ranging from 48-81 yr. They all had some morphologic abnormalities of cervical spines and/or temporomandibular joints. Sleep study revealed that all of them had sleep apnea; five of them were of obstructive type (obstructive group) while the remaining showed central type of sleep apnea (central group) predominantly. There were no statistically significant differences of the levels of apnea index, mean-nadir SO2 and the lowest SO2 between the obstructive group and the central group. No detectable differences of cephalographic measurements and MRI findings existed between the two groups either. In one patient, nasal-CPAP converted central apnea to normal breathing dramatically. Our observations indicate that the cause of central apnea in RA patients with temporomandibular lesions is collapse of upper airway, inducing inhibitory inputs from the mechanoreceptors in that region.
对10例（均为女性）患有类风湿性关节炎并伴有颞下颌关节破坏和颈椎病变的患者进行了整夜多导睡眠图研究。这些受试者的平均年龄为67.5岁，年龄范围在48至81岁之间。他们均存在颈椎和/或颞下颌关节的一些形态学异常。睡眠研究显示，他们均患有睡眠呼吸暂停；其中5例为阻塞型（阻塞组），其余主要表现为中枢型睡眠呼吸暂停（中枢组）。阻塞组和中枢组之间的呼吸暂停指数、平均最低血氧饱和度（SO2）和最低SO2水平无统计学显著差异。两组之间在头颅测量和MRI检查结果方面也未发现可检测到的差异。在1例患者中，鼻持续气道正压通气（nasal-CPAP）使中枢性呼吸暂停显著转变为正常呼吸。我们的观察结果表明，患有颞下颌病变的类风湿性关节炎患者出现中枢性呼吸暂停的原因是上气道塌陷，从而引发该区域机械感受器的抑制性输入。
