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过去十年间,阻塞性睡眠呼吸暂停(OSA)综合征受到广泛注意。作者简述本病的病理生理研究进展,其目的是利用病理生理学认识,为进一步建立合理治疗创造条件。 夜间发作的OSA的特性引出一系列继发的生理反应,后者反过来又构成OSA的许多临床表现和合并症。总的说来,这些生理反应及其所造成的临床表现可区分为两型:第一型是睡眠时反复出现窒息,其本质是突出的心血管和血流动力学变化;另一型是睡眠时重复憋醒,其本质为突出的神经精神方面的改变。 一、心血管反应与合并症 OSA患者反复发作夜间窒息引起若干生理反应,包括迷走介导的心律过缓和产生异位心搏,急性肺血管与系统血管收缩,导致肺高压与系统血压
Over the past decade, obstructive sleep apnea (OSA) syndrome has received widespread attention. The author briefly described the pathophysiology of the disease research progress, its purpose is to use pathophysiology, to create conditions for further rational treatment. The nature of OSA at night elicits a series of secondary physiological responses that in turn constitute many of the clinical manifestations and comorbidities of OSA. In general, these physiological responses and the clinical manifestations they cause can be divided into two types: the first type is repeated sleep apnea, its essence is prominent cardiovascular and hemodynamic changes; the other is sleep When repeated arousal, its essence is prominent neuropsychological changes. First, the cardiovascular response and comorbidities OSA patients recurrent nocturnal asphyxiation caused a number of physiological responses, including vagal-mediated arrhythmias and ectopic beats, acute pulmonary vascular and systemic vasoconstriction, resulting in pulmonary hypertension and systemic blood pressure