高原中枢性睡眠呼吸暂停的动态监测  

Continuously monitoring central sleep apnea on plateau

作　　者：曹征涛[1] 俞梦孙[1] 杨军[1] 朱金武[1] 刘园园[1] 罗永昌[1] 

机构地区：[1]空军航空医学研究所,北京100142

出　　处：《中华航空航天医学杂志》2013年第4期247-251,共6页Chinese Journal of Aerospace Medicine

基　　金：全军后勤科技“十二五”重大项目(AKJ11J005)

摘　　要：目的 观察不同条件下急进高原人员发生高原中枢性睡眠呼吸暂停(central sleep apnea,CSA)的特点规律,初步探讨CSA的发生程度与特征性生理指标变化之间的关系. 方法 12名男性健康受试者,分为预习服组、供氧组和对照组,每组各4人.所有受试者急进3800 m高原环境,低氧环境暴露48d.预习服组:进驻高原前10d,在常压低氧舱内进行连续10d(每天210 min)的阶梯式低氧暴露训练；供氧组:进入高原后前10d,受试者实施阶梯式低氧暴露方案；对照组:不做任何措施进入高原.试验过程中,用微动敏感床垫式睡眠监测设备对受试者进行中枢性睡眠呼吸暂停监测,并对受试者的红细胞计数、血红蛋白水平进行测量. 结果 ①高原低氧环境暴露的48 d内,12名受试者CSA指数均值先呈上升趋势,第18天升高至最大值9.62次/h,之后呈下降趋势,第48天降低至2.72次/h；CSA的发生率不断上升,到第16天达到最大值(41.67％),然后不断下降,到第48天达到8.33％.②低氧暴露前10 d,与对照组比较,预习服组和供氧组受试者CSA发生率降低(x2=12.984、12.984,P＜0.01)；预习服组和供氧组CSA指数均值小于1次/h,对照组CSA指数均值均大于1次/h.③受试者CSA指数均值与红细胞、血红蛋白浓度变化率呈显著正相关(r=0.747、0.934,P＜0.01). 结论 阶梯式低氧暴露措施可明显提升睡眠质量；CSA可作为人体高原低氧环境习服或慢性高原病发生程度的评价指标之一.Objective To dynamically observe characteristics and rules of the incidence of central sleep apnea (CSA) of the personnel who rushed to plateau with different ways,as well as preliminarily explore the correlation between the incidence of CSA and the changes of distinctive indexes for the subjects exposing in high altitude environment.Methods Twelve healthy subjects,who rushed to 3800 m plateau and stationed there under hypoxia environment for 48 d,were averagely divided into pre-acclimatization group,oxygen-supply group and control group.Pre-acclimatization group was experienced stepped altitude climbing training in hypobaric chamber 210 min a day for 10 days before entering plateau.Oxygen-supply group was implemented progressive hypoxic exposures in the first 10 d of entering plateau.Control group entered and stationed in plateau without any acclimatization training or extra oxygen supplement.The CSA episode of subjects was monitored by micro-movement sensitive mattress sleep measurement system and their blood red cell and blood hemoglobin were detected.Results ①During the 48 d exposure,CSA index of 12 subjects gradually raised and the maximal of CSA index was appeared on the 18th day (9.62 times/h) and declined to 2.72 times/h on the 48th day.The incidence of CSA was continuously increased and reached peak (41.67％) on the 16th day,then decreased to 8.33％ on the 48th day.②In the first 10 d,the incidence of CSA in the preacclimatization and oxygen groups was significantly lower than that in control group (x2 =12.984,12.984,P＜0.01).Moreover,the average value of CAS index in pre-acclimatization and oxygen group was lower than 1 time/h while control group's was higher than that.③The correlations between CSA index and variation ratio of blood red cell count and hemoglobin concentration were positive (r=0.747,0.934,P＜0.01).Conclusions Stepped exposing to hypoxia can significantly improve subject＇ s sleep quality.CSA index can be used as an indicator to evaluate hypoxia acclimatization or severity of ch

关 键 词：高海拔 睡眠呼吸暂停 中枢性 红细胞 血红蛋白类 习服 

分 类 号：R594.3[医药卫生—内科学]