正常成人与睡眠呼吸暂停患者颏舌肌神经肌肉活性特点

Neuromuscular properties of genioglossus activity in healthy adults and obstructive sleep apnea patients

正常呼吸运动中，上气道通畅性的维持与其对应扩张肌的神经肌肉调节活动密不可分，其中颏舌肌（genioglossus，GG）作为最大的上气道扩张肌，其开放上气道的作用最大。在健康个体中，颏舌肌的激活与上气道塌陷和咽腔阻力呈负相关性，吸气过程中的腔内负压可激活气道内机械感受器引发反射性肌肉活动，产生补偿性气道扩张。而在阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）患者，其颏舌肌的肌肉补偿作用并不能正常抵消气道负荷以维持通畅性，导致频繁出现阻塞性呼吸事件。已有多项研究显示，OSA患者睡眠期间上气道的易塌陷性与颏舌肌肌电（genioglossus electromyography，GGEMG）变化特点密切相关。本文就目前对健康成人睡眠相关GGEMG变化特点的研究进行总结归纳，并进一步分析OSA患者GGEMG活动相关病理生理机制。

Upper airway patency closely contact with neuromuscular airway regulation during respiratory, especially the activity of the pharyngeal dilators. The genioglossus is the largest pharyngeal dilators with its contraction playing the most important role in keeping the pharyngeal airway open. In healthy individuals, genioglossus activation shows a negative correlation with pharyngeal collapsibility and upper airway resistance. Negative pressure during inspiration can stimulate airway mechanoreceptors to produce a muscle reflex activity. However, in obstructive sleep apnea （OSA） patients, the muscles cannot always compensate for the increased mechanical load, resulting in frequent obstructive breathing events. A number of studies have shown that the collapsibility of upper airway during sleep in OSA patients is closely related to the activity of genioglossus electromyography（GGEMG）. The present article describes the current understanding regarding the characters of GGEMG during sleep in healthy adults, as well as the pathophysiology of GGEMG in OSA patients.