不同睡眠时相对正常人呼吸控制功能的影响  

Influence of Different Sleep Stages on Respiratory Regulation in Normal Humans

作　　者：韩芳[1] 陈尔璋[1] 魏海琳[1] 丁东杰[1] 何权瀛[1] 

机构地区：[1]北京大学人民医院呼吸科,北京100044

出　　处：《中国医学科学院学报》2004年第3期237-240,共4页Acta Academiae Medicinae Sinicae

摘　　要：目的了解不同睡眠时相对正常人呼吸控制功能的影响。方法通过鼻罩经鼻测定11例正常人在非快动眼睡眠穴NREM雪Ⅰ+Ⅱ、NREMⅢ+Ⅳ及快动眼睡眠穴REM雪睡眠期的口腔阻断压穴P0.1雪,呼吸中枢对低氧及高二氧化碳的反应性。结果在各睡眠时相熏P0.1均与清醒时无明显差异穴P>0.05雪,有效吸气阻抗穴P0.1·VT-1·Ti-1雪均升高穴P<0.05雪;在NREM睡眠期,低氧及高二氧化碳通气反应穴△VE/△SaO2、△VE/△PaCO2雪降低穴P<0.05雪,但P0.1的低氧及高二氧化碳反应穴△P0.1/△SaO2、△P0.1/△PaCO2雪均维持在清醒时的水平穴P>0.05雪;进入REM睡眠期,△P0.1/△SaO2、△P0.1/△PaCO2及△VE/△SaO2、△VE/△PaCO2均降低穴P<0.05雪。结论睡眠时,正常人呼吸中枢对上气道阻力增加可产生较有效的代偿,呼吸驱动穴P0.1雪维持在清醒时水平鸦在NREM睡眠期,呼吸中枢的化学敏感性降低不明显;进入REM睡眠期后,中枢的化学敏感性降低,易出现呼吸紊乱。Objective To understand the influence of different sleep stages on respiratory regulation in normal people. Methods We measured ventilation(VE)and occlusion pressure(P0.1) responses to hyperoxia hyper-capnia(△VE/△PaCO2, △P0.1/△PaCO2)and isocapnic hypoxia(△VE/△SaO2 and △P0.1/△SaO2)in eleven non-snoring healthy people during wakefulness and during non-rapid eye movement(NREM)Ⅰ+Ⅱ, NREM Ⅲ+Ⅳ, and rapid eye movement(REM)sleep stages. Results During NREMⅠ+Ⅱ and NREM Ⅲ+Ⅳ, the normal subjects showed no significant decrease in P0.1, △P0.1/△SaO2 and △P0.1/△PaCO2(P > 0.05), but △VE/△SaO2 and △VE/△PaCO2 decreased significantly(P < 0.05). During REM sleep, P0.1 maintained the level during wakefulness, but both hypoxic and hypercapnic responses decreased significantly(P < 0.05). Conclusions Sleep has significant influence on respiratory regulation in normal people. The respiratory drive(P0.1)in both NREM and REM sleep stages could maintain the awake level due to an effective compensation to the increase of upper airway resistance. The P0.1 responses to both hypoxia and hypercapnia decrease only in REM sleep stage, which is in consistent with the clinical phenomenon that sleep disordered breathing occurs in REM in normal people.

关 键 词：呼吸控制 睡眠时相 

分 类 号：R338.63[医药卫生—人体生理学]