吗啡改变呼吸控制，但不改变其他关键的阻塞性睡眠呼吸暂停表型:一个随机试验JF -欧洲呼吸杂志》乔和J - 10.1183/13993003.01344 -2019欧元六世- 55 - 6 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 - 2020/06/01 UR - //www.qdcxjkg.com/content/55/6/1901344.abstract N2 -意外opioid-related死亡增加。这些通常发生在睡眠中。吗啡等阿片类药物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综合症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咽部肌肉驱动力的减少，从而增加上气道的溃散。然而，吗啡对阻塞性睡眠呼吸暂停综合征(OSA)的四个关键表型原因(上气道收缩(咽部临界闭合压力;Pcrit)、咽肌反应性、呼吸唤醒阈值和睡眠呼吸控制(回路增益)尚不清楚。根据双盲、随机、交叉设计(ACTRN12613000858796)，研究了21名OSA患者(呼吸暂停低通气指数范围7-67事件·h−1)，为期两晚(1周洗脱期)。参与者一次接受40mg MS-Contin治疗，另一次接受安慰剂治疗。 Brief reductions in continuous positive airway pressure (CPAP) from the therapeutic level were delivered to induce airflow limitation during non-rapid eye movement (REM) sleep to quantify the four phenotypic traits. Carbon dioxide was delivered via nasal mask on therapeutic CPAP to quantify hypercapnic ventilatory responses during non-REM sleep.Compared to placebo, 40 mg of morphine did not change Pcrit (−0.1±2.4 versus −0.4±2.2 cmH2O, p=0.58), genioglossus muscle responsiveness (−2.2 (−0.87 to −5.4) versus −1.2 (−0.3 to −3.5) μV·cmH2O−1, p=0.22) or arousal threshold (−16.7±6.8 versus −15.4±6.0 cmH2O, p=0.41), but did reduce loop gain (−10.1±2.6 versus −4.4±2.1, p=0.04) and hypercapnic ventilatory responses (7.3±1.2 versus 6.1±1.5 L·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.Contrary to previous concerns, 40 mg of MS-Contin (morphine) does not impair pharyngeal muscle activity, airway collapsibility or alter arousal threshold, but breathing responses to CO2 are reduced, which could place certain OSA patients at risk of harm http://bit.ly/32Ljkac ER -