【摘 要】
:
呼吸中枢调控机制在正常呼吸维持中起关键作用.阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)发病呼吸中枢反应性的异常.因此,呼吸中枢通气反应性对判断患者的中枢调控功能,鉴别OSAHS 的中枢机制参与权重具有重要意义.目前,呼吸中枢通气反应性的判定主要方法包括:(1)通过测量口腔阻断压随CO2/O2 的改变,测定低氧反应
【机 构】
:
上海交通大学医学院附属瑞金医院呼吸与危重症医学科;上海交通大学医学院呼吸病研究所
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呼吸中枢调控机制在正常呼吸维持中起关键作用.阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)发病呼吸中枢反应性的异常.因此,呼吸中枢通气反应性对判断患者的中枢调控功能,鉴别OSAHS 的中枢机制参与权重具有重要意义.目前,呼吸中枢通气反应性的判定主要方法包括:(1)通过测量口腔阻断压随CO2/O2 的改变,测定低氧反应(ΔP0.1/ΔSaO2)和高CO2 反应(ΔP0.1/ΔPaCO2);(2)环路增益的测定:人工快速降低持续气道正压通气(CPAP)患者的面罩内压力并持续3min,造成通气量的减低(干扰性通气量),后快速增加CPAP 压力至原始压力,引起通气量增加(反应性通气量),反应性通气量变化(反应性通气量-静息通气量)与干扰性通气量变化(静息通气量-干扰性通气量)的比值即为环路增益,高环路增益提示呼吸中枢不稳定.
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