经鼻持续正压通气对OSAHS患者ABR的影响

目的　研究经鼻持续正压通气(continuouspositiveairwaypressurethroughthenares,nCPAP)治疗前后阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapnea/hypopneasyndrom ,OSAHS)患者听性脑干反应(ABR)各波潜伏期及波间期的变化,探讨OSAHS患者脑干电生理变化的解剖学及病理生理学基础。方法　对4 5例( 90耳)OSAHS患者及16例( 32耳)正常对照者行ABR测试及多导睡眠监测(polysomnography ,PSG) ,对其中34例( 6 8耳)OSAHS患者行nCPAP治疗前后ABR测试对比。结果　OSAHS患者的波Ⅲ、Ⅴ潜伏期及Ⅰ-Ⅲ、Ⅲ-Ⅴ、Ⅰ-Ⅴ波间期比正常对照组明显延长(P <0 .0 5 )。nCPAP治疗后波Ⅲ潜伏期较治疗前缩短,Ⅰ-Ⅲ波间期较治疗前缩短,Ⅲ-Ⅴ波间期较治疗前延长;nCPAP治疗后OSAHS患者呼吸紊乱指数及减血氧次数较治疗前明显下降(P <0 .0 5 )。结论　OS AHS患者的脑干听觉传导通路受损,与其高碳酸-低氧血症有密切关系。nCPAP治疗可以改善脑干听觉传导功能。

Effect of nCPAP on ABR in Patients with OSAHS

Objective By researching the auditory brainstem response(ABR) latency and interpeak latency intervals before and after continuous positive airway pressure through the nares(nCPAP), the experiment explored the pathophysiological and anatomical basis of electric physiological change in patients with obstructive sleep apnea/hypopnea syndrome(OSAHS).Methods The ABR of 45 OSAHS patients(90 ears) and control group(32 ears)was examined,the sleep of patients with OSAHS was monitored by polysomnography(PSG).The results of ABR before and after nCPAP were compared.Results 1.The latency of wave III? V and interpeak latency intervals of I-III,III-V,I-V of patients were longer than that of the control group.2.After nCPAP,wave III and interpeak latency intervals of I-III,III-V changed obviously.Conclusion 1.The OSAHS patients' auditory brainstem structure is impaired,which has relationship with high carbonic acid and low oxygen saturation. 2.Except wave III,produced by upper nucleus olivaris that is near the breathing center,effect of nCPAP on ABR of patients with OSAHS is not obvious.