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(OSA)的4个关键表型原因(上呼吸道收缩[Pcrit]、咽肌反应性、呼吸唤醒阈值和睡眠时呼吸控制[环路增益])的影响尚不清楚。根据双盲、随机、交叉设计(ACTRN12613000858796)，研究了21名OSA患者(AHI范围= 7-67事件·h−1)，为期2天(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。在治疗水平上，通过短暂降低持续气道正压(CPAP)来诱导非快速眼动睡眠期间的气流受限，以量化4种表型特征。在治疗性CPAP过程中，还通过鼻罩输送二氧化碳，以量化非快速眼动睡眠时高碳酸血症的通气反应。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)。与最近的临床发现一致的是，40mg MS-Contin不会系统地损害中重度OSA患者的气道收缩、咽肌反应性或唤醒阈值。 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 -