阻塞性睡眠呼吸暂停低通气综合征患者颏舌肌肌电活性分析

目的建立一种无创的颏舌肌(genioglossus,GG)肌电活性的检查方法,对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep hypopnea apnea sy nd rome,OSAHS)患者各睡眠阶段的GG肌电活性变化进行分析,探讨GG在OSAHS发病中的地位及其发病机理。方法①采用GG肌电活性测量与夜间多导睡眠监测(polysomnography,PSG)同步进行的方法,对符合OSAHS诊断标准的15例男性患者进行研究,分析比较清醒期、慢动眼睡眠期(non rapidey emovement,NREM)、快动眼睡眠期(rapideye movement,REM)GG肌电活性的差异;②分析呼吸暂停期间GG肌电活性的变化规律。结果①清醒期大于NREM期GG肌电指数,NREM期大于REM期GG肌电指数,差异均有统计学意义;②睡眠呼吸暂停期间GG肌电活性呈周期性改变。结论①氯化银球形表面电极可以准确测定GG肌电活性;②OSAHS患者NREM期、REM期GG肌电活性明显下降,是OSAHS发病因素之一;③睡眠呼吸呼吸暂停发作期间GG肌电活性呈规律性变化,是其与上气道负压相互作用的结果。

The study of genioglossus muscle activity on patients with obstructive sleep apnea hypopnea syndrome

OBJECTIVE Using AgCl intraoral elec- tromyographic electrode to establish a noninvasive method to record the genioglossus EMG. To analyze the influence of sleep stage on the genioglossus ac- tivity and its characteristics during the apnea period. METHODS The polysomnography and synchronous noninvasive genioglossus EMG were recorded in 15 male OSAHS cases for a whole night. The change charac- teristic of genioglossus muscle activity was studied. RESULTS The genioglossus muscle activity reduced significantly when the OSAHS patients fell into sleep. The genioglossus muscle activity consistently revealed periodical change during apnea epoch. Low genioglos- sus EMG activity were monitored at the onset of the collapse of the pharyngeal cavity and prominent discharge at the opening of the pharyngeal cavity. CONCLUSION This noninvasive method with intraoral surface electrode can record reliable genioglossus EMG activity. The reduced genioglossus EMG activity is an important factor in the pathogenesis of OSAHS. The genioglossus muscle activity consistently revealed periodical change during apnea epoch.