体表膈肌肌电在诊断睡眠呼吸暂停中的作用

发布时间：2018-07-13 16:57

【摘要】：目的观察体表膈肌肌电与食道膈肌肌电、食道压的相关性,探讨体表膈肌肌电是否能区分阻塞性与中枢性睡眠呼吸暂停事件。方法选择疑诊睡眠呼吸暂停综合征的患者10例,进行整夜多导睡眠监测的同时记录体表膈肌肌电、食道膈肌肌电和食道压监测。结果1.在发生阻塞性睡眠呼吸暂停事件时,体表膈肌肌电的最大均方根与食道膈肌肌电的最大均方根、食道压均呈正相关,相关系数分别为: 0.742±0.082、0.662±0.089,P均小于0.05。当阻塞性睡眠呼吸暂停包括气流恢复时,体表和食道膈肌肌电的最大均方根仍保持好的相关性(r=0.834±0.071,P0.05),而体表膈肌肌电与食道压的相关性则变为(r=0.474±0.196, P0.05)。2.常规多导睡眠仪的RIP判断中枢性睡眠呼吸暂停事件的次数为269次,显著大于以体表膈肌肌电(71次)、食道膈肌肌电(71次)和食道压(85次)判断的中枢性睡眠呼吸暂停事件的次数(P0.05);用体表膈肌肌电、食道膈肌肌电和食道压判断的中枢性睡眠呼吸暂停事件的次数无统计学差异(P0.05)。结论1.体表膈肌肌电与食道膈肌肌电具有良好的相关性,可以鉴别中枢性与阻塞性睡眠呼吸暂停事件。2.以呼吸体积描记系统作为呼吸中枢驱动的常规多导睡眠监测检查易将阻塞性睡眠呼吸暂停误诊为中枢性睡眠呼吸暂停事件,从而高估中枢性睡眠呼吸暂停发生率。3.与食道压相比,体表膈肌肌电、食道膈肌肌电能更好地反映阻塞性睡眠呼吸暂停事件过程中的中枢变化趋势。
[Abstract]:Objective to observe the correlation between diaphragm myography and esophageal pressure, and to investigate whether the diaphragm electromyography can distinguish obstructive sleep apnea from central sleep apnea. Methods Ten patients with suspected sleep apnea syndrome were selected and monitored with polysomnography at the same time as diaphragm, esophagus diaphragm and esophageal pressure. Result 1. In the event of obstructive sleep apnea (OSAS), the maximum RMS of the diaphragm myography on the body surface was positively correlated with the maximal RMS and esophageal pressure of the esophageal diaphragmatic myoelectric activity, and the correlation coefficients were 0.742 卤0.082 卤0. 662 卤0. 089 P < 0. 05, respectively. When obstructive sleep apnea (OSA) included airflow recovery, the maximal root mean square (RMS) of diaphragmatic myography in the body surface and esophagus remained positively correlated (r = 0.834 卤0.071, P 0.05), while the correlation between the electrical activity of the diaphragm and esophageal pressure was (r = 0.474 卤0.196, P 0.05) .2. The RIP of routine polysomnography was used to judge the number of central sleep apnea events. It was significantly higher than the number of central sleep apnea events (P 0.05) as judged by diaphragm myography (71 times), esophagus diaphragm myography (71 times) and esophageal pressure (85 times) (P0.05). There was no significant difference in the number of central sleep apnea events (P 0.05). Conclusion 1. There is a good correlation between diaphragmatic myography and esophageal diaphragmatic myography, which can distinguish central and obstructive sleep apnea events. 2. Routine polysomnography, which is driven by respiratory system, can easily misdiagnose obstructive sleep apnea as a central sleep apnea event, thus overestimating the incidence of central sleep apnea. Compared with esophageal pressure, the electrical energy of the diaphragm and the diaphragm on the body surface can better reflect the central change trend during obstructive sleep apnea events.
【学位授予单位】：广州医学院
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R766

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