咽部肌肉和结构与阻塞性睡眠呼吸暂停的关系

doi:10.6040/j.issn.1673-3770.0.2016.317

山东大学耳鼻喉眼学报 ›› 2016, Vol. 30 ›› Issue (5): 9-12.doi: 10.6040/j.issn.1673-3770.0.2016.317

咽部肌肉和结构与阻塞性睡眠呼吸暂停的关系

薛荣,张希龙

南京医科大学第一附属医院呼吸与危重症医学科, 江苏南京 210029

收稿日期:2016-07-20 出版日期:2016-10-20 发布日期:2016-10-20
通讯作者: 张希龙. E-mail:zhangxilong1952@163.com E-mail:1018411665@qq.co
作者简介:薛荣. E-mail:1018411665@qq.co

Relationship between obstructive sleep apnea and pharyngeal muscles and structure.

XUE Rong, ZHANG Xilong

Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China

Received:2016-07-20 Online:2016-10-20 Published:2016-10-20

摘要/Abstract

摘要： 上呼吸道包括鼻、咽、喉和胸腔外气管。研究最为关注的是咽部气道,这是阻塞性睡眠呼吸暂停综合征(OSAS)患者睡眠中发生部分或完全性阻塞的部位。在神经调节和化学调节下,咽部气道周围的肌肉可根据需要来调节气道口径和强直度。就睡眠期咽部肌肉和结构相互作用所维持的正常咽部气道,以及可能与睡眠呼吸障碍病理生理学相关的新研究作了阐述。

关键词: 咽部肌肉, 阻塞性睡眠呼吸暂停综合征

Abstract: The upper airway is composed of the nose, pharynx, larynx, and extrathoracic trachea. The segment of great interest is the pharynx, where partial or complete airway obstruction occurs during sleep in patients with obstructive sleep apnea syndrome(OSAS). Under the neural and chemical control, contraction of pharyngeal muscles surrounding the collapsible conduit of the pharynx modulates the size and stiffness according to the required purpose. The objective of this review is to describe normal pharyngeal airway maintenance achieved by interaction between the pharyngeal muscles and structures during sleep, and to share new information that may relate to the pathophysiology of sleep-disordered breathing.

Key words: Obstructive sleep apnea syndrome, Pharyngeal muscles

中图分类号:

R766.7

薛荣,张希龙. 咽部肌肉和结构与阻塞性睡眠呼吸暂停的关系[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 9-12.

XUE Rong, ZHANG Xilong. Relationship between obstructive sleep apnea and pharyngeal muscles and structure.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(5): 9-12.

参考文献

[1] Sériès F. Upper airway muscles awake and asleep[J]. Sleep Medicine Reviews, 2002, 6(3):229-242.
[2] Susarla S M, Thomas R J, Abramson Z R, et al. Biomechanics of the upper airway: changing concepts in the pathogenesis of obstructive sleep apnea[J]. International Journal of Oral and Maxillofacial Surgery, 2010, 39(12):1149-1159.
[3] Feroah T R, Forster H V, Fuentes C G, et al. Effects of spontaneous swallows on breathing in awake goats[J]. Journal of Applied Physiology, 2002, 92(5):1923-1935.
[4] Kuna S T, Smickley J S. Superior pharyngeal constrictor activation in obstructive sleep apnea[J]. American Journal of Respiratory and Critical Care Medicine, 1997, 156(3):874-880.
[5] Miki H, Hida W, Kikuchi Y, et al. Effects of pharyngeal lubrication on the opening of obstructed upper airway[J]. Journal of Applied Physiology, 1992, 72(6):2311-2316.
[6] Fuller D D, Williams J S, Janssen P L, et al. Effect of co-activation of tongue protrudor and retractor muscles on tongue movements and pharyngeal airflow mechanics in the rat[J]. The Journal of Physiology, 1999, 519(2):601-613.
[7] Remmers J E. Wagging the tongue and guarding the airway: reflex control of the genioglossus[J]. American Journal of Respiratory and Critical Care Medicine, 2001, 164(11):2013-2014.
[8] Edwards B A, White D P. Control of the pharyngeal musculature during wakefulness and sleep: implications in normal controls and sleep apnea[J]. Head & Neck, 2011, 33(S1):S37-S45.
[9] Mezzanotte W S, Tangel D J, White D P. Influence of sleep onset on upper-airway muscle activity in apnea patients versus normal controls[J]. American Journal of Respiratory and Critical Care Medicine, 1996, 153(6):1880-1887.
[10] Fogel R B, Trinder J, White D P, et al. The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controls[J]. The Journal of Physiology, 2005, 564(2):549-562.
[11] Genta P R, Owens R L, Edwards B A, et al. Influence of pharyngeal muscle activity on inspiratory negative effort dependence in the human upper airway[J]. Respiratory Physiology & Neurobiology, 2014, 201:55-59.
[12] Remmers J E. Wagging the tongue and guarding the airway: reflex control of the genioglossus[J]. American Journal of Respiratory and Critical Care Medicine, 2001, 164(11):2013-2014.
[13] Isono S. Obstructive sleep apnea of obese adults pathophysiology and perioperative airway management[J]. The Journal of the American Society of Anesthesiologists, 2009, 110(4):908-921.
[14] Kairaitis K, Verma M, Fish V, et al. Pharyngeal muscle contraction modifies peri-pharyngeal tissue pressure in rabbits[J]. Respiratory Physiology & Neurobiology, 2009, 166(2):95-101.
[15] Hudgel D W. The role of upper airway anatomy and physiology in obstructive sleep apnea[J]. Clinics in Chest Medicine, 1992, 13(3):383-398.
[16] Isono S, Tanaka A, Nishino T. Dynamic interaction between the tongue and soft palate during obstructive apnea in anesthetized patients with sleep-disordered breathing[J]. Journal of Applied Physiology, 2003, 95(6):2257-2264.
[17] Hollowell D E, Suratt P M. Mandible position and activation of submental and masseter muscles during sleep[J]. Journal of Applied Physiology, 1991, 71(6):2267-2273.
[18] Kato T, Katase T, Yamashita S, et al. Responsiveness of jaw motor activation to arousals during sleep in patients with obstructive sleep apnea syndrome[J]. Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine, 2013, 9(8):759.
[19] Tsai W H, Vazquez J C, Oshima T, et al. Remotely controlled mandibular positioner predicts efficacy of oral appliances in sleep apnea[J]. American Journal of Respiratory and Critical Care Medicine, 2004, 170(4):366-370.
[20] Ishikawa T, Isono S, Aiba J, et al. Prone position increases collapsibility of the passive pharynx in infants and small children[J]. American Journal of Respiratory and Critical Care Medicine, 2002, 166(5):760-764.

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咽部肌肉和结构与阻塞性睡眠呼吸暂停的关系

Relationship between obstructive sleep apnea and pharyngeal muscles and structure.

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