Kirby D A, Pinto J M, Weiss J W, Garpestad E, Zinkovska S
Children's Hospital, Beth Israel Hospital, Boston, MA 02115, USA.
Physiol Behav. 1995 Nov;58(5):919-23. doi: 10.1016/0031-9384(95)00150-h.
To study the effects of airway obstruction (AWO) and arousal on coronary blood flow, mean arterial pressure (MAP) and heart rate (HR), pigs were chronically instrumented with arterial catheters, Doppler flow probes on the left circumflex coronary artery, and electrodes for determination of sleep stages. A modified balloon catheter was placed in the trachea to obstruct the upper airway during sleep. Following control studies, the role of beta adrenergic receptors in hemodynamic responses to AWO was assessed by administering propranolol, a beta adrenoreceptor blocking agent. In control studies, during nonrapid eye movement sleep (NREM), MAP was 85 +/- 2 mmHg before AWO and increased by 8 +/- 2 mmHg upon arousal. Mean arterial pressure was lower during rapid eye movement (REM) sleep (64 +/- 2 mmHg) and the increase upon arousal was threefold greater (22 +/- 2 mmHg). Heart rate was similar in both sleep stages (NREM 123 +/- 5 bpm; REM 125 +/- 6 bpm) and increased significantly upon arousal (NREM, 11 +/- 2 bpm; REM, 18 +/- 3 bpm increase). Coronary blood flow was similar during both stages (NREM 44 +/- 5 ml/min; REM 44 +/- 6 ml/min) and increased by 13% (NREM) and 22% (REM) during arousal. Coronary vascular resistance increased significantly by 17% during arousal from AWO during REM sleep. All changes were significant at p < 0.05. Following beta adrenergic receptor blockade studies using propranolol, baseline HR was reduced in NREM sleep and HR and coronary blood flow increases during arousal from apnea were eliminated. Adrenoreceptor blockade studies suggest that these effects were mediated by the beta adrenergic component of the sympathetic nervous system.
为研究气道阻塞（AWO）和觉醒对冠状动脉血流、平均动脉压（MAP）及心率（HR）的影响，对猪进行长期仪器植入，在其体内置入动脉导管、左回旋冠状动脉上的多普勒血流探头以及用于确定睡眠阶段的电极。在气管中放置改良的球囊导管，以便在睡眠期间阻塞上呼吸道。在对照研究之后，通过给予β肾上腺素能受体阻滞剂普萘洛尔来评估β肾上腺素能受体在对AWO的血流动力学反应中的作用。在对照研究中，在非快速眼动睡眠（NREM）期间，AWO前MAP为85±2 mmHg，觉醒时升高8±2 mmHg。快速眼动（REM）睡眠期间平均动脉压较低（64±2 mmHg），觉醒时升高幅度大三倍（22±2 mmHg）。两个睡眠阶段的心率相似（NREM 123±5次/分钟；REM 125±6次/分钟），觉醒时显著增加（NREM增加11±2次/分钟；REM增加18±3次/分钟）。两个阶段的冠状动脉血流相似（NREM 44±5毫升/分钟；REM 44±6毫升/分钟），觉醒时分别增加13%（NREM）和22%（REM）。REM睡眠期间从AWO觉醒时冠状动脉血管阻力显著增加17%。所有变化在p<0.05时具有统计学意义。在使用普萘洛尔进行β肾上腺素能受体阻断研究后，NREM睡眠时基线HR降低，呼吸暂停觉醒时HR和冠状动脉血流增加被消除。肾上腺素能受体阻断研究表明，这些效应是由交感神经系统的β肾上腺素能成分介导的。
