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1、11-慢性心衰中的中枢性睡眠呼吸暂停(11-centralsleepapneainchronicheartfailure)CentralsleepapneainchronicheartfailureLiWei,(90405130),LiMingjia(90405134),HuangXiantao(904-5133),WangKang(904-5135),Zhangheavy(90405138)Diseasephysiologyexperiment04groups,04basicclasses[Keywords]CHF,CSA,BNPChron
2、icheartfailure(Chronic,heart,failure,CHF)isaheartfailurecausedbycardiovascularorothermultisystemdisorders.Heartfailureisstillacardiovasculardiseasewithahighmorbidityandmortality,andistheleadingcauseofhospitalizationinpeopleovertheageof65.Centralsleepapnea(Centralsleep,apnea
3、,CSA)issleepdisorderedbreathing(Sleepdisordered,breathing,SDB)alossgeneratedduringthesuctionprocessduetothefailureoftheshortcentralrespiratoryrhythm,obstructivesleepdisorderandexpiratorypause(OSA)onthecontrary.CSAandOSAarecommoninpatientswithseverechronicheartfailure,andstu
4、dieshaveshownthatCSAisassociatedwithasignificantprognosisforheartfailure,whereasOSAisnot.CSAandCHFarereciprocalcausation,aviciouscycle,whichseriouslyaffectstheprognosisofpatients.ThisreviewsummarizesthemechanismsofactionofCSAandCHF,theclinicalsymptomatictreatmentofCSA,andth
5、enewguidingroleofBNPinthediagnosisofCHFassociatedwithCSA.Mechanismsofactionof1.CSAandCHF:Itincludestwoaspects:CHFproducesandaggravatesCSA;CSAaggravatesCHFandaffectsprognosis.Pathogenesisof1.1.CSA:Thecontrolofrespiratoryrhythmin1.1.1.normalbodyincludestwopoints:thecontroloft
6、heautonomicnervousmetabolismsystem,thecontrolofrespiratoryrhythm,andthecontroloftherespiratoryrhythmbythewakingstate.Theautonomicnervousmetabolicsystemcontrolsrespiratoryrhythms,i.e.,chemicalsignalssuchaschangesinCO2andH+concentrationsthatregulaterespiration,whichisthemosts
7、ensitiveandrapidregulationofrespiratorymovements.Thecontrolofrespiratoryrhythminwakingstate.Thehumanbodyintheawakestate,awakeningsystemlocatedinthebrainstemreticularsystembystimulatingsignaltransduction,activationofneuronstoactivatetheupperponsdischarge,therespiratorycenter
8、alsolocatedinthebrainstem,therebymaintainingthenormalrespiratoryrhythm.Inthesleepa