解读阻塞性睡眠呼吸暂停患者身体对间歇性缺氧反应的生理信号之间的时间延迟。

IF 2.3 4区 医学 Q3 BIOPHYSICS
Geng Li, Mengwei Zhou, Xiaoqing Huang, Changjin Ji, Tingting Fan, Jinkun Xu, Huahui Xiong, Yaqi Huang
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引用次数: 0

摘要

目的:间歇性缺氧是阻塞性睡眠呼吸暂停(OSA)的主要病理现象,会引起心血管反应,导致搏出量(SV)、血压(BP)和心率(HR)等血液动力学参数发生变化。然而,以往的研究却得出了截然不同的结论,如认为呼吸暂停时 SV 会增加或减少。从类似测量中得出相反结论的一个关键原因可能是忽略了获取反应信号的时间延迟。通过分析缺氧时收集到的信号,我们旨在建立标准,以确定呼吸暂停开始与生理参数反应开始之间的延迟时间。我们对 66 例不同严重程度的 OSA 患者睡眠期间的血氧饱和度(SpO2)、经皮氧压(TcPO2)以及血液动力学参数 SV、HR 和 BP 进行了监测,以观察身体对缺氧的反应并确定上述参数的延迟时间。数据分析采用 Kruskal-Wallis 检验、Quade 检验和 Spearman 检验。我们发现,同时获取各种参数不可避免地涉及不同程度的反应延迟(7.12 - 25.60 秒)。血液动力学参数的延迟时间明显短于 SpO2 和 TcPO2(p < 0.01)。OSA 严重程度影响 SpO2、TcPO2、SV、MBP 和 HR 的反应延迟(P < 0.05)。SV 延迟时间与呼吸暂停-低通气指数呈负相关(r = -0.4831,p < 0.0001)。剔除延迟时间的影响后才能确定真实的机体反应,这是解决类似研究得出相互矛盾结论问题的关键。本研究提出的方法和重要发现为揭示缺氧时心血管系统的真实反应提供了关键信息,表明正确的信号分析对于正确解释心血管血流动力学反应现象、探索其生理和病理生理机制具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Time delays between physiological signals in interpreting the body's responses to intermittent hypoxia in obstructive sleep apnea.

Objective.Intermittent hypoxia, the primary pathology of obstructive sleep apnea (OSA), causes cardiovascular responses resulting in changes in hemodynamic parameters such as stroke volume (SV), blood pressure (BP), and heart rate (HR). However, previous studies have produced very different conclusions, such as suggesting that SV increases or decreases during apnea. A key reason for drawing contrary conclusions from similar measurements may be due to ignoring the time delay in acquiring response signals. By analyzing the signals collected during hypoxia, we aim to establish criteria for determining the delay time between the onset of apnea and the onset of physiological parameter response.Approach.We monitored oxygen saturation (SpO2), transcutaneous oxygen pressure (TcPO2), and hemodynamic parameters SV, HR, and BP, during sleep in 66 patients with different OSA severity to observe body's response to hypoxia and determine the delay time of above parameters. Data were analyzed using the Kruskal-Wallis test, Quade test, and Spearman test.Main results.We found that simultaneous acquisition of various parameters inevitably involved varying degrees of response delay (7.12-25.60 s). The delay time of hemodynamic parameters was significantly shorter than that of SpO2and TcPO2(p< 0.01). OSA severity affected the response delay of SpO2, TcPO2, SV, mean BP, and HR (p< 0.05). SV delay time was negatively correlated with the apnea-hypopnea index (r= -0.4831,p< 0.0001).Significance.The real body response should be determined after removing the effect of delay time, which is the key to solve the problem of drawing contradictory conclusions from similar studies. The methods and important findings presented in this study provide key information for revealing the true response of the cardiovascular system during hypoxia, indicating the importance of proper signal analysis for correctly interpreting the cardiovascular hemodynamic response phenomena and exploring their physiological and pathophysiological mechanisms.

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来源期刊
Physiological measurement
Physiological measurement 生物-工程:生物医学
CiteScore
5.50
自引率
9.40%
发文量
124
审稿时长
3 months
期刊介绍: Physiological Measurement publishes papers about the quantitative assessment and visualization of physiological function in clinical research and practice, with an emphasis on the development of new methods of measurement and their validation. Papers are published on topics including: applied physiology in illness and health electrical bioimpedance, optical and acoustic measurement techniques advanced methods of time series and other data analysis biomedical and clinical engineering in-patient and ambulatory monitoring point-of-care technologies novel clinical measurements of cardiovascular, neurological, and musculoskeletal systems. measurements in molecular, cellular and organ physiology and electrophysiology physiological modeling and simulation novel biomedical sensors, instruments, devices and systems measurement standards and guidelines.
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