口呼吸时的颏下刺激和声门上阻力

Submental stimulation and supraglottic resistance during mouth breathing.

作者信息

Hida W, Okabe S, Miki H, Kikuchi Y, Kurosawa H, Takishima T, Shirato K

机构信息

First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.

出版信息

Respir Physiol. 1995 Jul;101(1):79-85. doi: 10.1016/0034-5687(95)00011-2.

DOI:10.1016/0034-5687(95)00011-2

PMID:8525124

Abstract

We studied submental stimulation on supraglottic resistance (Rsg) in 5 normals and 6 patients with obstructive sleep apnea. We then examined the most effective sites of stimulation in the submental regions, and the relationships between Rsg and stimulation frequency and voltage in the supine position. Inspiratory and expiratory Rsg's were obtained as the slope of the linear portion of the pressure-flow relation determined at zero flow. Before stimulation, inspiratory and expiratory Rsg's were 0.76 +/- 0.06 (means +/- SE) and 0.61 +/- 0.02 cmH2O.L-1.sec, respectively, in normals, and 1.04 +/- 0.20 and 0.92 +/- 0.29 cmH2O.L-1.sec, respectively, in patients. Stimulation in the proximal half submental region with surface electrodes 1 cm apart decreased inspiratory and expiratory Rsg's in patients, and inspiratory Rsg in normals. Inspiratory Rsg measured in this submental region showed a stimulation frequency-and voltage-dependency in both groups, but expiratory Rsg did not. These findings suggest that submental stimulation in the proximal half region widens the supraglottic airway during mouth breathing and probably involves the upper airway muscles.

摘要

我们研究了颏下刺激对5名正常人和6名阻塞性睡眠呼吸暂停患者声门上阻力（Rsg）的影响。然后，我们检查了颏下区域最有效的刺激部位，以及仰卧位时Rsg与刺激频率和电压之间的关系。吸气和呼气时的Rsg通过在零流量时确定的压力-流量关系线性部分的斜率获得。刺激前，正常人吸气和呼气时的Rsg分别为0.76±0.06（均值±标准误）和0.61±0.02cmH2O·L-1·s，患者分别为1.04±0.20和0.92±0.29cmH2O·L-1·s。使用相距1cm的表面电极在颏下区域近端进行刺激，可降低患者吸气和呼气时的Rsg，以及正常人吸气时的Rsg。在该颏下区域测量的吸气Rsg在两组中均显示出刺激频率和电压依赖性，但呼气Rsg则没有。这些发现表明，颏下区域近端的刺激在口呼吸时可扩宽声门上气道，可能涉及上气道肌肉。