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目的:观察睡眠状态下阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道扩张肌肌电活性的变化,探讨其在OSAHS中的作用及意义。方法:对中、重度OSAHS患者69例(OSAHS组)及健康志愿者20例(对照组)于诱导睡眠后分别行颏舌肌、腭帆张肌和腭帆提肌等上气道扩张肌肌电图的检测并与诱导睡眠前比较。结果:①清醒状态下OSAHS组上气道扩张肌肌电水平较对照组高(均P<0.01);②与清醒状态比较,睡眠状态下OSAHS组上气道扩张肌肌电水平显著下降(均P<0.01);③从清醒状态到睡眠状态,OSAHS组上气道扩张肌肌电水平下降幅度明显大于对照组(均P<0.01)。结论:OSAHS患者清醒状态下上气道扩张肌肌电活性代偿性升高及睡眠状态下失代偿是该病发生的重要病理生理机制。
OBJECTIVE: To observe the changes of myoelectrical activity of upper airway dilators in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) under sleep condition and to explore their roles and significance in OSAHS. Methods: Sixty-nine patients (OSAHS group) and 20 healthy volunteers (control group) undergoing moderate to severe OSAHS were induced to sleep with genioglossus, palatal-saphenous muscle and palatal- The electrograms were detected and compared with those before induction of sleep. Results: (1) EMG levels in the OSAHS group were significantly higher than those in the control group (all P <0.01); ② Compared with the awake state, the EMG levels in the OSAHS group were significantly decreased P <0.01). ③ From the awake state to the sleep state, the EMG level of the airway dilatation muscle in OSAHS group was significantly lower than that in the control group (all P <0.01). CONCLUSIONS: The compensatory increase of myoelectrical activity of upper airway dilatation muscle and decompensation under sleep state in OSAHS patients are an important pathophysiological mechanism of the disease.