阻塞型睡眠呼吸暂停综合征患者夜间脑血流变化研究  

Cerebral Hemodynamics in Obstructive Sleep Apnea Syndrome

作　　者：肖永龙[1] 倪秀石[2] 张德平[1] 杭美琴[1] 郑培德[1] 戴令娟[1] 侯杰[1] 

机构地区：[1]南京大学医学院附属鼓楼医院呼吸科,南京210008 [2]南京大学医学院附属鼓楼医院神经科,南京210008

出　　处：《南京大学学报（自然科学版）》2003年第5期569-575,共7页Journal of Nanjing University（Natural Science）

摘　　要：采用经颅多谱勒(TCD)测定5例阻塞型睡眠呼吸暂停综合征(OSAS)患者睡眠前、睡眠中及睡眠后大脑中动脉血流速度,同步进行多导睡眠图监测,分析比较患者呼吸暂停/低通气呼吸事件对脑血流的影响.结果显示OSAS患者晚间入睡前TCD测定大脑中动脉平均血流速(MFV)值为(79.6±5.3)cm/s,次晨觉醒后大脑中动脉MFV值为(77.4±8.6)cm/s.所有311个呼吸事件相关的大脑中动脉MFV峰值为(94.5±20.5)cm/s,MFV谷值为(44.9±12.1)cm/s,MFV变化度为116.2±41.2％.MFV变化度与呼吸事件持续时间呈正相关(r=0.763,P<0.05),与SaO2变化值也呈正相关(r=0.560,P<0.05).REM期睡眠MFV变化度为142.8±55.4％,1期、2期及3+4期睡眠的MFV变化度分别为113.2±33.0％、106.2±30.7％及115.7±49.4％.以上结果表明OSAS患者夜间呼吸暂停或低通气造成脑血流速度剧烈变化,其中尤以上气道恢复通气后引起的脑血流速度下降更明显,REM期睡眠脑血流变化比其它睡眠时相更显著.Five obstructive sleep apnea syndrome patients 'cerebral blood velocity were recorded with TCD while polysomnography was taking synchronously before, in and after sleep. Middle cerebral artery mean flow velocity in five patients was (79. 6 ± 5. 3)cm/s before sleep, (77. 4 ± 8. 6) cm/s after sleep. Middle cerebral artery MFVmax in all 311 sleep apneas/hypopneas was (94. 5 ± 20. 5) cm/s, MFVmin was (44. 9± 12. 1) cm/s. Change rate of MFV was 116. 2± 41. 2% and correlated positive with length of sleep apnea/hypopnea (r = 0.763, P<0.05)and desaturation of oxygen (r = 0.560, P<0.05). Change rate of MFV of sleep apnea/hypopnea in REM sleep was 142.8±55.4%, 113.2±33.0% ,106.2±30.7% , and 115.7±49.4% in 1, 2 , 3 + 4 stage sleep. These results indicated that MFV fluctuation occured during sleep apnea/hypopnea in sleep apnea syndrome is apparent and more severe in REM sleep stage.

关 键 词：阻塞型睡眠呼吸暂停综合征 夜间 脑血流 脑卒中 动脉血流速度 呼吸事件 

分 类 号：R563.8[医药卫生—呼吸系统]