慢性間歇低氧與交感神經異常興奮的研究進展_《中國呼吸與危重監護雜志》

作者：

葉亮 , 李慶云 ,  李敏

上海交通大學醫學院附屬瑞金醫院（上海 200025）;

關鍵詞：

慢性間歇低氧交感神經異常興奮

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睡眠過程中反復出現呼吸暫停造成的間歇低氧是阻塞性睡眠呼吸暫停低通氣綜合征( OSAHS) 的主要病理生理學特點, 它能夠導致自主神經, 特別是交感神經興奮性異常增
高[1] , 后者可能是OSAHS合并心血管疾病包括高血壓、充血性心力衰竭、心肌梗死以及心律失常的主要危險因素之一[2,3] 。現將慢性間歇低氧( chronic intermittent hypoxia,
CIH) 所致交感神經異常興奮的相關研究作一綜述。

引用本文： 葉亮,李慶云,李敏. 慢性間歇低氧與交感神經異常興奮的研究進展. 中國呼吸與危重監護雜志, 2009, 09(6): 609-611. doi: 復制

1.	方向華, 王文志, 陳捷, 等. 社區心腦血管病危險因素長期干預效果評價. 中華醫學雜志, 2000, 80: 94 ～97.
2.	Hedner J, Ejnell H, Sellgren J, et al. Is high and fluctuating muscle nerve sympathetic activity in the sleep aponea syndrome of pathogenetic importance for the development of hypertension? J Hypertens Suppl, 1988, 6: S529-S531.
3.	Somers VK, Dyken ME, Clary MP, et al. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest, 1995 , 96 :1897-1904.
4.	Zakrzewska-Pniewska B, Nojszewska M, Przybylowski T, et al.Clinical versus electrophysiological assessment of dysautonomia in obstructive sleep apnea syndrome. J Clin Neurophysiol, 2004, 21 :435-439.
5.	Ziegler MG,Mills PJ, Loredo JS, et al. Effect of continuous positive airway pressure and placebo treatment on sympathetic nervous activity in patients with obstructive sleep apnea. Chest, 2001 , 120 :887-893.
6.	Heitmann J, Ehlenz K, Penzel T, et al. Sympathetic activity is reduced by nCPAP in hypertensive obstructive sleep apnoea patients. Eur Respir J, 2004, 23: 255-262.
7.	Imadojemu VA, Mawji Z, Kunselman A, et al. Sympathetic chemoreflex responses in obstructive sleep apnea and effects of continuous positive airway pressure therapy. Chest, 2007, 131:1406-1413.
8.	Leuenberger UA, Brubaker D, Quraishi S, et al. Effects of intermittent hypoxia on sympathetic activity and blood pressure in humans. Auton Neurosci, 2005, 121: 87-93.
9.	Lusina SJ, Kennedy PM, Inglis JT, et al. Long-term intermittent hypoxia increases sympathetic activity and chemosensitivity during acute hypoxia in humans. J Physiol, 2006, 575: 961-970.
10.	Park DH, Shin CJ, Hong SC, et al. Correlation between the severity of obstructive sleep apnea and heart rate variability indices. JKorean Med Sci, 2008, 23: 226-231.
11.	Peng YJ, Prabhakar NR. Effect of two paradigms of chronic intermittent hypoxia on carotid body sensory activity. J Appl Physiol, 2004, 96: 1236-1242.
12.	Rey S, Del Rio R, Alcayaga J, et al. Chronic intermittent hypoxia enhances cat chemosensory and ventilatory responses to hypoxia. J Physiol, 2004, 560: 577-586.
13.	Peng YJ, Yuan G, Ramakrishnan D, et al. Heterozygous HIF-1alpha deficiency impairs carotid body-mediated systemic responses and reactive oxygen species generation in mice exposed to intermittent hypoxia. J Physiol, 2006, 577: 705-716.
14.	Lesske J, Fletcher EC, Bao G, et al. Hypertension caused by chronic intermittent hypoxia--influence of chemoreceptors and sympathetic nervous system. J Hypertens, 1997, 15: 1593-1603.
15.	Peng YJ, Overholt JL, Kline D, et al. Induction of sensory long-term facilitation in the carotid body by intermittent hypoxia: implications for recurrent apneas. Proc Natl Acad Sci U S A, 2003, 100: 10073-10078.
16.	Prabhakar NR, Peng YJ, Jacono FJ, et al. Cardiovascular alterations by chronic intermittent hypoxia: importance of carotid body chemoreflexes. Clin Exp Pharmacol Physiol, 2005, 32: 447-449.
17.	Phillips CL, Yang Q, Williams A, et al. The effect of short-term withdrawal from continuous positive airway pressure therapy on sympathetic activity and markers of vascular inflammation in subjects with obstructive sleep apnoea. J Sleep Res, 2007, 16: 217 -225.
18.	Verberne AJ, Owens NC. Cortical modulation of the cardiovascular system. Prog Neurobiol, 1998, 54: 149-168.
19.	Netzer N, Werner P, Jochums I, et al. Blood flow of the middle cerebral artery with sleep-disordered breathing. Stroke, 1998, 29 : 87 -93.
20.	Leslie WD, Wali S, Kryger M. Blood flow of the middle cerebral artery with sleep-disordered breathing: correlation with obstructive hypopneas. Stroke, 1999, 30: 188-190.
21.	Leuenberger UA, Hogeman CS, Quraishi S, et al. Short-term intermittent hypoxia enhances sympathetic responses to continuous hypoxia in humans. J Appl Physiol, 2007, 103: 835-842.
22.	Huang J, Tamisier R, Ji E, et al. Chronic intermittent hypoxia modulates nNOS mRNA and protein expression in the rat hypothalamus. Respir Physiol Neurobiol, 2007 , 158: 30-38 .
23.	Phillips SA, Olson EB, Morgan BJ, et al. Chronic intermittent hypoxia impairs endothelium-dependent dilation in rat cerebral and skeletal muscle resistance arteries. Am J Physiol Heart Circ Physiol,2004, 286: H383-H393.
24.	Bao G, Metreveli N, Li R, et al. Blood pressure response to chronic episodic hypoxia: role of the sympathetic nervous system. J Appl Physiol, 1997, 83: 95-101.
25.	Kumar GK, Rai V, Sharma SD, et al. Chronic intermittent hypoxia induces hypoxia-evoked catecholamine efflux in adult rat adrenal medulla via oxidative stress. J Physiol, 2006, 575: 229-239.
26.	Ramanathan L, Gozal D, Siegel JM. Antioxidant responses to chronic hypoxia in the rat cerebellum and pons. J Neurochem, 2005, 93: 47-52.
27.	Yuan G, Nanduri J, Bhasker CR, et al. Ca2+ / calmodulin kinasedependent activation of hypoxia inducible factor 1 transcriptional activity in cells subjected to intermittent hypoxia. J Biol Chem,2005, 280: 4321-4328.
28.	Sarada SK, Himadri P, Ruma D, et al. Selenium protects the hypoxia induced apoptosis in neuroblastoma cells through upregulation of Bcl-2 . Brain Res, 2008 , 1209 : 29-39.
29.	Yu AY, Frid MG, Shimoda LA, et al. Temporal, spatial, and oxygenregulated expression of hypoxia-inducible factor-1 in the lung. Am J Physiol, 1998, 275: L818-L826.

1. 方向華, 王文志, 陳捷, 等. 社區心腦血管病危險因素長期干預效果評價. 中華醫學雜志, 2000, 80: 94 ～97.
2. Hedner J, Ejnell H, Sellgren J, et al. Is high and fluctuating muscle nerve sympathetic activity in the sleep aponea syndrome of pathogenetic importance for the development of hypertension? J Hypertens Suppl, 1988, 6: S529-S531.
3. Somers VK, Dyken ME, Clary MP, et al. Sympathetic neural mechanisms in obstructive sleep apnea. J Clin Invest, 1995 , 96 :1897-1904.
4. Zakrzewska-Pniewska B, Nojszewska M, Przybylowski T, et al.Clinical versus electrophysiological assessment of dysautonomia in obstructive sleep apnea syndrome. J Clin Neurophysiol, 2004, 21 :435-439.
5. Ziegler MG,Mills PJ, Loredo JS, et al. Effect of continuous positive airway pressure and placebo treatment on sympathetic nervous activity in patients with obstructive sleep apnea. Chest, 2001 , 120 :887-893.
6. Heitmann J, Ehlenz K, Penzel T, et al. Sympathetic activity is reduced by nCPAP in hypertensive obstructive sleep apnoea patients. Eur Respir J, 2004, 23: 255-262.
7. Imadojemu VA, Mawji Z, Kunselman A, et al. Sympathetic chemoreflex responses in obstructive sleep apnea and effects of continuous positive airway pressure therapy. Chest, 2007, 131:1406-1413.
8. Leuenberger UA, Brubaker D, Quraishi S, et al. Effects of intermittent hypoxia on sympathetic activity and blood pressure in humans. Auton Neurosci, 2005, 121: 87-93.
9. Lusina SJ, Kennedy PM, Inglis JT, et al. Long-term intermittent hypoxia increases sympathetic activity and chemosensitivity during acute hypoxia in humans. J Physiol, 2006, 575: 961-970.
10. Park DH, Shin CJ, Hong SC, et al. Correlation between the severity of obstructive sleep apnea and heart rate variability indices. JKorean Med Sci, 2008, 23: 226-231.
11. Peng YJ, Prabhakar NR. Effect of two paradigms of chronic intermittent hypoxia on carotid body sensory activity. J Appl Physiol, 2004, 96: 1236-1242.
12. Rey S, Del Rio R, Alcayaga J, et al. Chronic intermittent hypoxia enhances cat chemosensory and ventilatory responses to hypoxia. J Physiol, 2004, 560: 577-586.
13. Peng YJ, Yuan G, Ramakrishnan D, et al. Heterozygous HIF-1alpha deficiency impairs carotid body-mediated systemic responses and reactive oxygen species generation in mice exposed to intermittent hypoxia. J Physiol, 2006, 577: 705-716.
14. Lesske J, Fletcher EC, Bao G, et al. Hypertension caused by chronic intermittent hypoxia--influence of chemoreceptors and sympathetic nervous system. J Hypertens, 1997, 15: 1593-1603.
15. Peng YJ, Overholt JL, Kline D, et al. Induction of sensory long-term facilitation in the carotid body by intermittent hypoxia: implications for recurrent apneas. Proc Natl Acad Sci U S A, 2003, 100: 10073-10078.
16. Prabhakar NR, Peng YJ, Jacono FJ, et al. Cardiovascular alterations by chronic intermittent hypoxia: importance of carotid body chemoreflexes. Clin Exp Pharmacol Physiol, 2005, 32: 447-449.
17. Phillips CL, Yang Q, Williams A, et al. The effect of short-term withdrawal from continuous positive airway pressure therapy on sympathetic activity and markers of vascular inflammation in subjects with obstructive sleep apnoea. J Sleep Res, 2007, 16: 217 -225.
18. Verberne AJ, Owens NC. Cortical modulation of the cardiovascular system. Prog Neurobiol, 1998, 54: 149-168.
19. Netzer N, Werner P, Jochums I, et al. Blood flow of the middle cerebral artery with sleep-disordered breathing. Stroke, 1998, 29 : 87 -93.
20. Leslie WD, Wali S, Kryger M. Blood flow of the middle cerebral artery with sleep-disordered breathing: correlation with obstructive hypopneas. Stroke, 1999, 30: 188-190.
21. Leuenberger UA, Hogeman CS, Quraishi S, et al. Short-term intermittent hypoxia enhances sympathetic responses to continuous hypoxia in humans. J Appl Physiol, 2007, 103: 835-842.
22. Huang J, Tamisier R, Ji E, et al. Chronic intermittent hypoxia modulates nNOS mRNA and protein expression in the rat hypothalamus. Respir Physiol Neurobiol, 2007 , 158: 30-38 .
23. Phillips SA, Olson EB, Morgan BJ, et al. Chronic intermittent hypoxia impairs endothelium-dependent dilation in rat cerebral and skeletal muscle resistance arteries. Am J Physiol Heart Circ Physiol,2004, 286: H383-H393.
24. Bao G, Metreveli N, Li R, et al. Blood pressure response to chronic episodic hypoxia: role of the sympathetic nervous system. J Appl Physiol, 1997, 83: 95-101.
25. Kumar GK, Rai V, Sharma SD, et al. Chronic intermittent hypoxia induces hypoxia-evoked catecholamine efflux in adult rat adrenal medulla via oxidative stress. J Physiol, 2006, 575: 229-239.
26. Ramanathan L, Gozal D, Siegel JM. Antioxidant responses to chronic hypoxia in the rat cerebellum and pons. J Neurochem, 2005, 93: 47-52.
27. Yuan G, Nanduri J, Bhasker CR, et al. Ca2+ / calmodulin kinasedependent activation of hypoxia inducible factor 1 transcriptional activity in cells subjected to intermittent hypoxia. J Biol Chem,2005, 280: 4321-4328.
28. Sarada SK, Himadri P, Ruma D, et al. Selenium protects the hypoxia induced apoptosis in neuroblastoma cells through upregulation of Bcl-2 . Brain Res, 2008 , 1209 : 29-39.
29. Yu AY, Frid MG, Shimoda LA, et al. Temporal, spatial, and oxygenregulated expression of hypoxia-inducible factor-1 in the lung. Am J Physiol, 1998, 275: L818-L826.

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《中國呼吸與危重監護雜志》

慢性間歇低氧與交感神經異常興奮的研究進展

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《中國呼吸與危重監護雜志》

慢性間歇低氧與交感神經異常興奮的研究進展

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