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31.
目的 观察一组AHI接近的阻塞性睡眠呼吸暂停综合征(OSAS)患者中上气道阻塞部位对多导睡眠监测(PSG)图及临床表现的影响。方法选取36例AHI为30—40的成年男性OSAS患者行再次整夜PSG,加同步上气道及食道压力监测确定上气道最低阻塞部位。比较上气道最低阻塞部位在软腭水平、舌根水平和下咽水平的不同患者中PSG相关参数:平均SaO2、最低SaO2、最长阻塞性呼吸暂停事件时间、呼吸暂停事件中SaO2下降率(dSaO2/dt)、微觉醒指数;以及部分临床表现参数:白日嗜睡程度、入睡前收缩压/清晨收缩压、入睡前舒张压/清晨舒张压以及高血压发生率。结果平均SaO2、最长阻塞性呼吸暂停事件时间和入睡前收缩压/清晨收缩压比值在3种不同上气道最低阻塞部位患者中差异无显著性(P〉0.05),但与软腭水平相比,舌根水平和下咽水平的最低Sa02降低(P〉0.05),dSaO2/dt(%/s)比值增高(P〈0.05),微觉醒指数及白日嗜睡评分增高(P〈0.01),入睡前舒张压/清晨舒张压比值降低(P〈0.05),最低SaO2〈80%的发生率增高(P〈0.01)以及高血压的发生率增高(P〈0.01)。结论AHI接近的OSAS患者上气道阻塞部位在舌根水平以下者与软腭以上水平者相比,阻塞性呼吸暂停事件的致缺氧效率和程度提高,OSAS的临床表现加重。 相似文献
32.
Dr. med. Thorsten Schäfer Heike Vogelsang 《Somnologie - Schlafforschung und Schlafmedizin》2002,6(2):79-84
Summary Question of the study Nasal continuous positive airway pressure (CPAP) prevents collapse of the upper airway during sleep in patients with obstructive sleep apnea provided that a positive transmural pressure can be maintained during inspiration. We examined pressure-flow characteristics in seven CPAP and bilevel devices during spontaneous breathing.
Methods The CPAP devices were set to a pressure level of 9.8 hPa (10 cm H2 O) and adapted to a pneumotachograph using a standard CPAP hose and an outlet valve. We continuously measured flow, volume and pressure during resting ventilation and increasing voluntary hyperventilation and analysed the dependence of the variables on a breath-to-breath basis.
Results Mean CPAP pressures differed between the devices (9.9 – 10.6 hPa) despite the same settings. In all machines pressure fell during inspiration to 8.4 – 9.8 hPa and increased during expiration to 11.1 – 11.7 hPa. This effect increased with higher flow rates. Maximum expiratory pressures rose to 12 – 19 hPa at peak flow rates of 2 l/s, mean expiratory pressures to 9.5 – 16 hPa. Inspiratory pressures dropped to 8.5 – 4.5 hPa (minimum) and 10.5 – 6.0 (mean). Bilevel devices showed a higher stability than CPAP devices. Pressure swings during the respiratory cycle increased the additional work of breathing.
Conclusions Due to differences in mean and effective CPAP levels CPAP devices are not simply exchangeable but should be individually adapted. Patients with higher minute ventilation might benefit from more stable CPAP machines. The impact on patients' compliance remains to be evaluated. 相似文献
Methods The CPAP devices were set to a pressure level of 9.8 hPa (10 cm H
Results Mean CPAP pressures differed between the devices (9.9 – 10.6 hPa) despite the same settings. In all machines pressure fell during inspiration to 8.4 – 9.8 hPa and increased during expiration to 11.1 – 11.7 hPa. This effect increased with higher flow rates. Maximum expiratory pressures rose to 12 – 19 hPa at peak flow rates of 2 l/s, mean expiratory pressures to 9.5 – 16 hPa. Inspiratory pressures dropped to 8.5 – 4.5 hPa (minimum) and 10.5 – 6.0 (mean). Bilevel devices showed a higher stability than CPAP devices. Pressure swings during the respiratory cycle increased the additional work of breathing.
Conclusions Due to differences in mean and effective CPAP levels CPAP devices are not simply exchangeable but should be individually adapted. Patients with higher minute ventilation might benefit from more stable CPAP machines. The impact on patients' compliance remains to be evaluated. 相似文献
33.
Brief interruptions of REM sleep are considered to be part of the REM episode. The maximum allowable duration of such an interruption, which is used to define the end of the REM episode, is currently a matter of debate. Making measurements on individual REM cycles, inter-REM interval analysis was carried out to determine whether the generally adopted 15 minute empirical rule for this maximum needs to be extended to 25 minutes as suggested by several including Kobayashi et al. Our results show that there is no reason to alter the 15 minute rule and that measurements which do not take into account the time-of-night effect may be misleading. The proportion of interrupted REM episodes observed in our population of healthy adults is high. We have therefore also examined in some detail the phenomenology of the temporal evolution of the structure and content of the interrupted REM episodes. Both showed a definite change over the night: the interruptions in the earlier episodes tend to return the system to slow wave sleep while those in the later episodes tend to return it to wake. It is hypothesized that these interruptions reflect a measure of REM sleep pressure and its interaction with both slow wave sleep and wake pressures. 相似文献
34.
悬雍垂保留在悬雍垂腭咽成形术中的作用 总被引:1,自引:0,他引:1
目的 探讨悬雍垂保留在悬雍垂腭咽成形术(UPPP)中的作用。方法 比较43例UPPP与43例保留悬雍垂的改良UPPP的术中术后并发症、术后症状改善程度以及术后咽腔测量结果。结果 术中术后大出血、开放性鼻音、进流食返呛人鼻腔等并发症:改良UPPP明显低于UPPP(P<0.05);咽异物感:改良UPPP极明显低于UPPP(P<0.01)。术后1年患者主观症状改善程度:明显改善者,改良UPPP高于UPPP,无改善者,UPPP高于改良UPPP,有显著性差异(P<0.05)。术后1年咽腔扩大程度:下腭咽横径、前后径,改良UPPP较UPPP两者均明显扩大(P<0.05)。结论 UPPP中保留悬雍垂可明显降低术中术后大出血、开放性鼻音、进流食返呛人鼻腔、咽异物感等并发症,术后症状明显改善,咽腔得到明显扩大。 相似文献
35.
Juan Carlos Gómez-Esteban Juan Jose Zarranz Elena Lezcano Fernando Velasco Roberto Ciordia Idoia Rouco Jose Losada Iker Bilbao 《Movement disorders》2006,21(7):983-988
The aim of this research was to quantify sleep problems in patients suffering from Parkinson's disease by means of the new Parkinson's Disease Sleep Scale (PDSS) and to correlate such problems with the possible influence of current drug treatment. A total of 70 patients (36 men and 34 women) with a diagnosis of Parkinson's disease were enrolled. Their mean age was 69.7 +/- 8.2 years, and duration of disease was 7.4 +/- 4.8 years. All patients completed the PDSS and the Unified Parkinson's Disease Rating Scale (UPDRS Parts I-IV). Drug consumption and doses were registered. The mean score on the PDSS scale was 109.23 +/- 19.75 and on the UPDRS III scale was 25.24 +/- 11.35. The lowest scores were obtained in Item 3 (sleep fragmentation): 5.53 (2.46); and in Item 8 (nocturia): 5.75 (2.91). There was a weak correlation between the PDSS and UPDRS III (cc = -0.355, P = 0.003), PDSS and UPDRS I (cc = -0.272, P = 0.02), and PDSS and UPDRS IV (cc = -0.416, P < 0.001). Motor conditions, mental state, and drug complications influence sleep quality. Although this effect was significant, it was not of a great magnitude. Dopaminergic drugs did not increase daytime sleepiness. As a whole, sleep quality in patients who took dopaminergic agonists did not differ from that of patients who took levodopa in monotherapy. 相似文献
36.
Thermoregulatory heat-loss responses at high ambient temperatures were studied in intact cats and those with bilateral electrolytic lesions in the pontine tegmentum during wakefulness (W), slow-wave sleep (SWS), paradoxical sleep (PS) and PS without atonia induced by the lesions. Panting (respiratory rate 90/min) was present W, SWS, and in some cases, during PS. The percentage of the PS episodes with panting was directly related ambient temperature. In intact cats at 30 °C, panting occurred in 8% of the PS episodes; at 35 °C, in 52%, and at 40 °C, in 77%. The percentage of PS episodes with panting higher in the pontine-lesioned cats (90% at 35 °C), probably another indication of the altered thermoregulation of such animals. Thermoregulatory responses to heat load, and thermoregulation in general, have previously been shown to be suppressed in PS. Because hypothalamic thermosensitive neurons lack thermal responses during PS, the partial activation of heat-loss responses observed here may depend upon the function of extrahypothalamic brainstem areas. 相似文献
37.
目的 比较高血压合并阻塞性睡眠呼吸暂停患者的短期血压变异性。方法 将155例分为对照组、高血压组、高血压合并轻度或中重度阻塞性睡眠呼吸暂停组,EE较患者不同活动状态的短期血压变异性。结果 高血压合并中重度阻塞性睡眠呼吸暂停组患者睡眠期间和早晨血压变异系数分别为:收缩压18.69、21.32;舒张压19.41、23.61,明显高于其他各组。结论 夜间睡眠期间和早晨短期血压变异性增加,是高血压合并中重度阻塞性睡眠呼吸暂停患者夜间和早晨心血管事件发生率增加的重要危险因素。 相似文献
38.
采用LabVIEW技术完成对心电、呼吸、无创血氧和无创血压信号的采集与处理,而后通过MATLAB模糊测量系统对采集的人体生理信号进行模糊预测分析。通过实验检验了人体生理信号检测、处理和模糊预测分析方法的可靠性。LabVIEW技术对人体生理信号的模糊预测分析是有效的,可用于检测阻塞性睡眠呼吸暂停患者的生理状态信号。 相似文献
39.
The case report describes a distinct variant of non-REM (Rapid Eye Movement) arousal parasomnia, sleepwalking type, featuring repetitive abrupt arousals, mostly from slow-wave sleep, and various automatisms and semi-purposeful behaviours. The frequency of events and distribution throughout the night presented as a continuous status of parasomnia (' status parasomnicus '). The patient responded well to treatment typically administered for adult NREM parasomnias, and after careful review of the clinical presentation, objective findings and treatment outcome, sleep-related epilepsy was ruled out in favour of parasomnia. 相似文献
40.
Thellea K. Leveque Le Yu David C. Musch Ronald D. Chervin David N. Zacks 《Sleep & breathing》2007,11(4):253-257
Patients with obstructive sleep apnea (OSA), in comparison to controls, have increased levels of circulating epinephrine and
norepinephrine, both of which are risk factors for the development of central serous chorioretinopathy (CSCR). The aim of
this pilot study was to investigate the frequency of symptoms that suggest OSA in CSCR patients and normal controls. The Berlin
Questionnaire, a validated research tool to assess risk for OSA, was administered to 29 patients who met the criteria for
active, acute, non-steroid-induced CSCR and 29 controls matched for age and sex. In this retrospective case-controlled study,
the main outcome measure was increased risk for OSA. The mean age of the patients was 47.8 years (range 29–72) and the mean
age of controls was 47.3 years (range 25–70). Seventy-six percent (22) of both groups were men. Survey scores showed 58.6%
(17) of patients with CSCR to be at an increased risk for OSA compared to 31.0% (nine) of controls. A conditional logistic
regression analysis showed that the CSCR group had a higher proportion with an increased risk for OSA compared to the control
group (odds ratio=3.67; 95% CI: 1.02, 13.14; P = 0.046). Patients with CSCR may be more likely than other adults to have OSA, and screening for this sleep disorder should
be considered in this population. Further research is warranted to determine whether sleep apnea may contribute to the development
of CSCR, and to assess whether treatment of sleep apnea might offer a new therapeutic option for some patients with CSCR. 相似文献