@article {Martins1901344, author = {Martins, Rodrigo T. and Carberry, Jayne C. and Wang, David and Rowsell, Luke and Grunstein, Ronald R. and Eckert, Danny j}， title ={吗啡改变呼吸控制，但不改变其他关键OSA表型:随机试验}，location-id = {1901344}， year = {2020}， doi = {10.1188 /13993003.01344-2019}， publisher ={欧洲呼吸学会}，摘要={阿片类药188bet官网地址物相关的意外死亡正在增加。这些通常发生在睡眠中。阿片类药物如吗啡可加重阻塞性睡眠呼吸暂停(OSA)。因此，患有阻塞性睡眠呼吸暂停的人可能更容易受到吗啡的伤害。可能的机制包括呼吸抑制和减少驱动咽部肌肉增加上呼吸道溃散。然而，吗啡对OSA的4个关键表型原因(上呼吸道湿瘫[Pcrit]、咽部肌肉反应性、呼吸唤醒阈值和睡眠呼吸控制[循环增益])的影响尚不清楚。根据双盲、随机、交叉设计(ACTRN12613000858796)，对21例OSA (AHI范围=7个67个事件)患者进行了2个晚上(1周洗脱)的研究。参与者在一次治疗中接受40毫克的MS-Contin，另一次接受安慰剂。在非快速眼动睡眠期间，短暂降低持续气道正压(CPAP)以诱导气流限制，以量化4个表型性状。在治疗性CPAP中，也通过鼻罩释放二氧化碳，以量化非快速眼动睡眠期间的高碳酸通气反应。Compared to placebo, 40 mg of morphine did not change Pcrit (-0.1{\textpm}2.4 versus -0.4{\textpm}2.2 cmH2O, p=0.58), genioglossus muscle responsiveness (-2.2[-0.87 to -5.4] versus -1.2[-0.3 to -3.5]microV/cmH2O, p=0.22), or arousal threshold (-16.7{\textpm}6.8 versus -15.4{\textpm}6.0 cmH2O, p=0.41), but did reduce loop gain (-10.1{\textpm}2.6 versus -4.4{\textpm}2.1 dimensionless, p=0.04) and hypercapnic ventilatory responses (7.3{\textpm}1.2 versus 6.1{\textpm}1.5 L{\textperiodcentered}min-1, p=0.006).Concordant with recent clinical findings, 40 mg of MS-Contin does not systematically impair airway collapsibility, pharyngeal muscle responsiveness or the arousal threshold in moderately severe OSA patients. However, consistent with blunted chemosensitivity, ventilatory control is altered.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Tomazini Martins reports grants from NHMRC, during the conduct of the study.Conflict of interest: Dr. Carberry reports grants from National Health and Medical Research Council (NHMRC) of Australia, NeuroSleep-Centre for Research Excellence, grants from NHMRC, during the conduct of the study.Conflict of interest: Dr. Wang reports grants from National Health and Medical Research Council of Australia (NHMRC), during the conduct of the study.Conflict of interest: Dr. Rowsell reports grants from National Health and Medical Research Council of Australia (NHMRC), during the conduct of the study.Conflict of interest: Dr. Grunstein reports grants from National Health and Medical Research Council of Australia (NHMRC), during the conduct of the study; grants from Collaborative Research Centre (CRC) Consortium Grant between the Australian Government, Academia and Industry, other from Teva, other from Merck, outside the submitted work.Conflict of interest: Dr. Eckert reports grants from National Health and Medical Research Council of Australia (NHMRC), during the conduct of the study; grants and personal fees from Bayer, grants and personal fees from Apnimed, grants from Collaborative Research Centre (CRC-P) Consortium Grant between the Australian Government, Academia and Industry, outside the submitted work.}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/early/2020/03/04/13993003.01344-2019}, eprint = {//www.qdcxjkg.com/content/early/2020/03/04/13993003.01344-2019.full.pdf}, journal = {European Respiratory Journal} }