TY -的T1 -吗啡改变呼吸控制而不是其他关键阻塞性睡眠呼吸暂停综合症表型:一个随机试验JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.01344 -2019欧元SP - 1901344 AU -马丁斯,罗德里戈·t . AU - Carberry杰恩c . AU -王,大卫•Rowsell AU -路加福音AU - Grunstein,罗纳德·r . AU -埃克特,丹尼·J·Y1 - 2020/01/01 UR - //www.qdcxjkg.com/content/early/2020/03/04/13993003.01344 - 2019. -抽象N2 -意外opioid-related死亡增加。这些经常发生在睡眠中。吗啡等阿片类药物会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受到吗啡伤害的风险可能更大。可能的机制包括呼吸抑制和咽部肌肉驱动的减少，以增加上呼吸道的塌陷。然而，吗啡对阻塞性睡眠呼吸暂停的4个关键表型原因(上气道折叠[Pcrit]、咽部肌肉反应、呼吸唤醒阈值和睡眠时通气控制[环路增益])的影响尚不清楚。根据双盲、随机、交叉设计(ACTRN12613000858796)， 21名OSA患者(AHI范围= 7-67个事件·h−1)在2个晚上(1周洗脱)进行研究。参与者一次接受40毫克的MS-Contin治疗，另一次接受安慰剂治疗。从治疗水平短暂降低持续气道正压(CPAP)，以诱导非快速眼动睡眠期间的气流限制，以量化4个表型特征。在治疗性CPAP中，二氧化碳也通过鼻罩传递，以量化非快速眼动睡眠期间的高碳酸通气反应。与安慰剂相比,40毫克的吗啡并没有改变Pcrit(−0.1±2.4和cmH2O−0.4±2.2,p = 0.58), genioglossus肌肉反应(−2.2(0.87−−5.4)与−1.2(0.3−−3.5)microV / cmH2O, p = 0.22),或兴奋阈值(−16.7±6.8和cmH2O−15.4±6.0,p = 0.41),但降低环路增益(−10.1±2.6与无量纲−4.4±2.1,p = 0.04)和hypercapnic通气反应(7.3±1.2和6.1±1.5 L·分钟−1,p = 0.006)。与最近的临床研究结果一致的是，在中度重度阻塞性睡眠呼吸暂停患者中，40mg的MS-Contin并不会系统地损害气道塌陷、咽部肌肉反应性或觉醒阈值。 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. ER -