摘要
目的探讨睡眠呼吸暂停综合征（ＳＡＳ）患者体位及肥胖因素引起的肺功能改变与夜间低氧血症的关系。方法选择确诊为ＳＡＳ患者３４例，分别于坐位和仰卧位检查肺功能和血气分析，整夜多导睡眠仪监测。肺功能、血气指标和理想体重％（ＩＢＷ％）分别与呼吸暂停指数（ＡＩ）、＜９０％Ｔ（ＳａＯ２低于９０％时间占总睡眠时间百分比）进行相关分析。结果患者由坐位改为仰卧位，ＰａＯ２、肺活量（ＶＣ％）、补呼气量（ＥＲＶ）、功能残气量（ＦＲＣ％）、残气容积（ＲＶ％）、肺总量（ＴＬＣ％）均出现有统计学意义的降低。ＡＩ与仰卧位ＶＣ％、ＴＬＣ％呈正相关。＜９０％Ｔ与坐位ＰａＯ２、ＥＲＶ呈负相关。ＩＢＷ％与坐、仰卧位ＶＣ％和ＥＲＶ呈负相关，与坐位ＦＲＣ呈负相关。ＩＢＷ％与＜９０％Ｔ呈正相关。结论伴有肥胖的ＯＳＡＳ患者，体位改变及肥胖因素影响患者肺功能。
Objective To explore the relationship between the changes of lung function resulted from position changes and obesity, and nocturnal hypoxemia in patients with obstructive sleep apnea syndrome. Method 34 patients with obstructive sleep apnea syndrome were detected by polysomnography with lung function and blood gas analysis in sitting and supine positions during wake, and the relationship between results of lung function and blood gas analysis, IBW% to the AI, and <90%T (percentage of the duration of SaO2 below 90% to total sleep time) was analyzed. Result The mean age of the patients was 44±13 years. The AI was 36±22 time·hour-1. On changing from sitting to supine position, PaO2、VC%、ERV、FRC、FRC%、RV%、TLC% decreased significantly, especially ERV and FRC%, which decreased 47% and 29% respectively. AI had positive correlation with VC% (r=0.477, P<0.01) and TLC%(r=0.443, P<0.01) in supine position, <90% T had negative correlation with PaO2(r=-0.479,P<0.01) and ERV (r=-0.416, P<0.05) in sitting position. The IBW% had negative correlation with VC% in sitting (r=-0.547, P<0.01) and supine position (r=-0.491, P<0.01). IBW% also had negativie correlation with ERV in sitting (r=-0.523, P<0.01) and supine (r=-0.413, P<0.01) position and FRC (r=-0.402, P<0.05) in sitting position. The IBW% had positive correlation with the <90%T(r=0.514, P<0.01). Conclusion These results suggest that positional changes and obesity have effects on lung function in patients with OSAS, and lead to the deterioration of hypoxemia during apnea.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
1998年第8期486-488,共3页
Chinese Journal of Tuberculosis and Respiratory Diseases
