睡眠呼吸暂停进程中自主神经功能活动的变化趋势
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江苏高校优势学科建设工程(PAPD2010-2013);南京医科大学第一附属医院/江苏省人民医院创新团队工程(IRT-016);江苏省“科教兴卫工程”医学重点学科基金(XK200719)开放课题(XK19200901);教育部留学回国人员科研启动基金(20101174)


The trend of autonomic nervous system activity in the process of sleep apnea
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    摘要:

    目的:探讨阻塞性与中枢性呼吸暂停进程中自主神经功能活动的特点。方法:对30例阻塞性睡眠呼吸暂停综合征患者进行整夜标准多导睡眠监测,选取睡眠呼吸事件发生期间及其前后各15 s的3个连续区间,提取各区间相应的RR间期变化的时间序列资料及其相关背景。分析比较阻塞性与中枢性呼吸事件进程中R-R间隔的变化趋势。结果:阻塞性呼吸暂停进程中RR间隔变异有明显差异,与呼吸暂停发生前相比较,RR的平均值-标准差和均方根在呼吸暂停期间最小,在呼吸暂停结束后增大。提示阻塞性呼吸暂停期RR间隔最短,心率变异最小,但整体波动较均一。而中枢性呼吸暂停进程中RR间隔无显著性变化。结论:阻塞性和中枢性呼吸暂停进程中自主神经功能活动的趋势不同。交感与副交感神经系统功能活动在阻塞性呼吸事件前后实现了2次交替,即交感活动在阻塞性呼吸事件发生过程中逐步增强而在其结束后逐步回复。而中枢性呼吸事件进程中则无此变化。

    Abstract:

    Objective:To discuss the characteristic trends of autonomic nervous system (ANS) activity in the processes of obstructive sleep apnea (OA) and central sleep apnea (CA). Methods:Thirty patients who were diagnosed as obstructive sleep apnea syndrome by polysomnograph were enrolled in the study. The RR intervals and relative data were extracted during the apnea,as well as a 15-second period before and after the apnea. The different trends of heart rate variability(HRV) for OA and CA were analyzed and compared. Results:HRV parameters varied significantly in the process of OA. The mean value,SD and rMSSD of RR intervals shifted slower level during OA,but returned to high level after OA. It suggested that RR interval was short during OA and with less variability. The HRV parameters showed no obvious changing in the process of CA. Conclusion:Different trends of ANS activity could be suggested during the processed of OA and CA. In other words,the sympathetic activity shifted to higher level during OA,and returned to a much lower level after it. In comparison,CA presented no significant change of ANS activity.

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张娜娜,魏先梅,殷 敏,程 雷,Miyazaki S.睡眠呼吸暂停进程中自主神经功能活动的变化趋势[J].南京医科大学学报(自然科学版),2013,(6):816-819

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  • 收稿日期:2013-03-17
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  • 在线发布日期: 2013-06-25
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