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目的通过了解阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠呼吸暂停事件前后咽腔呼吸压力变化的规律性,探讨咽腔呼吸压力对OSAHS形成、发展的可能影响。方法采用导管测压法,与多导睡眠图(PSG)同步实时监测8例OSAHS患者和9例健康受试者睡眠状态下鼻咽、口咽和喉咽等部位的咽腔呼吸压力;测平均呼吸压和呼吸负压持续时间比。结果健康受试者睡眠中咽腔呼吸压力波形有良好的规则性,各次呼吸压力波形具有相似性和周期性,呼吸负压持续时间比<0.5。OSAHS患者OSAHS事件发作期咽腔呼吸压力波动剧烈,压力波形不规则,吸气负压极大,平均呼吸压较健康人高1～2个数量级,可高达-990Pa,呼吸负压持续时间比>0.55;OSAHS事件发作间期,咽腔呼吸压力波形规则,并具有一定的周期性,与呼吸暂停事件发作时的压力波形完全不同,而与健康人睡眠中的咽腔呼吸压力波形极为相像,但发作间期的平均呼吸压和呼吸负压持续时间比与健康人相比差异有统计学意义(P<0.05)。结论OSAHS患者睡眠呼吸事件发作间期的咽腔呼吸压力在本质上不同于健康人睡眠中的咽腔呼吸压力,其特性表明,OSAHS患者咽腔结构和功能的病变对气道内呼吸气流的影响是固有的,并不因临床发作与否而影响其持续性,在发作期这种影响表现得更为明显,说明非正常咽腔呼吸压力对咽部软组织产生的生物力学作用对OSAHS发病机制是重要的。
Objective To understand the regularity of respiratory pressure in pharyngeal cavity before and after sleep apnea-hypopnea syndrome (OSAHS) in obstructive sleep apnea-hypopnea syndrome (OSAHS) and explore the possible influence of pharyngeal respiratory pressure on the formation and development of OSAHS. Methods Nasopharyngeal, oropharyngeal and hypopharyngeal pharyngeal respiratory pressure were measured in 8 OSAHS patients and 9 healthy volunteers synchronously with polysomnography (PSG) by catheter manometry. The mean Respiratory pressure and respiratory pressure duration ratio. Results In healthy subjects, pharyngeal respiration pressure waveform during sleep had good regularity. Respiratory pressure waveforms were similar and periodic in all subjects. The ratio of respiratory negative pressure duration was less than 0.5. OSAHS patients with OSAHS during the attack phase pharyngeal respiratory pressure fluctuations, irregular pressure waveform, inspiratory negative pressure is great, the average respiratory pressure than healthy people 1 to 2 orders of magnitude, up to -990Pa, breathing negative pressure duration> 0.55; OSAHS event seizure and pharyngeal respiration pressure wave rules, and have a certain periodicity, and the pressure waveform at the time of apnea episode is completely different, but very similar with the pharyngeal respiration pressure waveform during sleep, but The mean duration of breath pressure and duration of breath negative pressure in interictal period were significantly higher than those in healthy subjects (P <0.05). Conclusions The pharyngeal respiration pressure of OSAHS patients during sleep apnea episode is different from the pharyngeal respiratory pressure in healthy people during sleep episodes. The characteristics of OSAHS patients’ pharyngeal structure and function lesions on airway respiratory airflow are Inherent, and does not affect the persistence of clinical seizures during the onset of this effect was more obvious, indicating that abnormal pharyngeal respiratory pressure on the pharyngeal soft tissue biomechanical effects on OSAHS pathogenesis is important of.