睡眠呼吸暂停患者低氧通气反应敏感性及白天二氧化碳潴留机制  

Mechanism of circadian rhythm on chemoreflex sensitivity and the carbon dioxide reserve in patients with sleep apnea

作　　者：张庆龙[1] 何忠明[1] 郭红[1] 李剑平[1] 韩芳[2] Zhang Qinglong ,He Zhongming, Guo Hong, Li J ianping, Nan Fang.(Department of Respiratory and Critical Care Medicine, Karamay Central Hospital, Xinjiang Uygar Autonomous Regin, Karamay 834000, Chin)

机构地区：[1]新疆维吾尔自治区克拉玛依市中心医院呼吸与危重症医学科,834000 [2]北京大学人民医院呼吸与危重症医学科,100044

出　　处：《国际呼吸杂志》2018年第5期392-396,共5页International Journal of Respiration

基　　金：国家自然科学基金（81360016）

摘　　要：呼吸调节功能在睡眠呼吸暂停发病中起重要作用，而低氧通气反应性和二氧化碳水平在呼吸调节中又起到关键作用，低氧的净效应取决于缺氧暴露的模式、持续时间和强度，这些因素相互作用导致广泛不同的生理反应，诱导增强或抑制通气，增强程度取决于二氧化碳水平。这与二氧化碳潴留和化学反应敏感度受昼夜节律的影响有关，本综述分析了呼吸可塑性在睡眠中维持睡眠呼吸暂停患者呼吸稳定性的作用，睡眠呼吸暂停与呼吸不稳定，呼吸道可塑性和影响呼吸不稳定性的因素，昼夜节律的影响及其临床意义。Breathing control dysfunction plays important role in the development of sleep apnea, hypoxic ventilatory reactivity （HVR） and carbon dioxide （CO2） levels also play a key role in respiratory control. The HVR is a complex interplay between several distinct mechanisms whose net effect varies depending on the pattern, duration, and intensity of hypoxic exposure. These interactions result in widely disparate physiological responses that induce either facilitation or depression of ventilation, furthermore, depending on COz levels. The possibility that chemoreflex sensitivity and the CO2 reserve is modulated by circadian rhythm. This review has begun to describe complicated and plastic interactions in the relay circuits between the peripheral chemoreceptors and the ventilatory control circuits within the central nervous system. Long-term facilitation of ventilation and upper airway muscle activity during sleep, sleep apnea and breathing instability, respiratory plasticity and impact on breathing stability, circadian rhythms and clinical significance.

关 键 词：睡眠呼吸暂停 低氧通气反应性 昼夜节律 二氧化碳潴留 

分 类 号：R766[医药卫生—耳鼻咽喉科]