去甲肾上腺素再摄取抑制剂联合抗毒蕈碱剂治疗阻塞性睡眠呼吸暂停的研究进展  

Research progress of norepinephrine reuptake inhibitor combined with antimuscarinic in the treatment of obstructive sleep apnea

作　　者：王娟[1] 刘维英[2] 叶育才 付文丽 张莎 李乐萍 WANG Juan;LIU Weiying;YE Yucai;FU Wenli;ZHANG Sha;LI Leping(The First Clinical Medical College of Lanzhou University,Lanzhou 730030,Gansu,China;Department of Respiratory and Critical Care Medicine,The First Hospital of Lanzhou University,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730030 [2]兰州大学第一医院呼吸与危重症医学科,甘肃兰州730030

出　　处：《中国临床药理学与治疗学》2023年第6期714-720,共7页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：甘肃自然科学基金(21JRIRA074)。

摘　　要：阻塞性睡眠呼吸暂停因睡眠中反复发生呼吸暂停和(或)低通气,导致慢性间歇性低氧伴高碳酸血症、睡眠结构紊乱,进而对全身器官造成损害。近年来研究发现,除了上气道结构异常,咽部扩张肌功能减退、上气道的不稳定也易造成上气道狭窄,且与睡眠中去甲肾上腺素的撤退和乙酰胆碱的增多有关,联合使用去甲肾上腺素再摄取抑制剂和抗毒蕈碱剂可通过增加颏舌肌活动、改善气道稳定性等途径降低阻塞性睡眠呼吸暂停的严重程度,且安全性较好。Obstructive sleep apnea is caused by repeated apnea and/or hypopnea during sleep,which leads to chronic intermittent hypoxia with hypercapnia and sleep structure disorder,and then causes damage to systemic organs.Recent studies have found that in addition to the abnormal structure of the upper airway,the dysfunction of the pharyngeal dilator muscle and the instability of the upper airway are also prone to cause upper airway stenosis,and are related to the withdrawal of norepinephrine and the increase of acetylcholine during sleep.The combined use of norepinephrine reuptake inhibitor and muscarinic can reduce the severity of OSA by increasing genioglossus activity and improving airway stability,with good safety.

关 键 词：睡眠呼吸暂停 阻塞性 药物治疗 去甲肾上腺素再摄取抑制剂 抗毒蕈碱剂 

分 类 号：R965.2[医药卫生—药理学]