摘要
目的 在于阐明临界压 (Pcrit)与睡眠呼吸暂停低通气综合征 (SAHS)患者病情严重程度的关系 ,以及Pcrit对SAHS患者选择治疗方式上的指导意义。方法 分别对 165名男性行多导睡眠图检查 ,其中 3 3名为正常对照 ;用压力振荡技术 (Forcedoscillationtechnique ,FOT)对其余 13 2名男性SAHS患者 (分为S1、S2 、S3NOCPAP及S3CPAP4组 )进行压力和流量测定 ,根据最大通气量与压力的关系 ,用外推法在气流为零时作图解出Pcrit。 14名男性SAHS患者行射频组织缩积术 (Radiofre quencytissuevolumereduction ,RFTVR)治疗。结果 PcritS1组为 ( 1 2± 0 6)cmH2 O ,S2 组为 ( 1 7± 0 8)cmH2 O ,S3NOCPAP组为( 2 2± 0 8)cmH2 O ,S3CPAP组为 ( 2 6± 0 7)cmH2 O ;在S3CPAP组的AHI指数中OAI及MAI均非常显著地高于OHI(t =7 464 ,P <0 0 1;及t=3 718,P <0 0 1) ,其OAI亦非常显著地高于S3NOCPAP组的OAI(t=3 80 4,P <0 0 1) ;舌根RFTVR治疗使上气道阻力从 ( 6 3 8± 1 46)cmH2 O·L-1·s-1降低为 ( 4 5 8± 1 5 7)cmH2 O·L-1·s-1(P <0 0 5 ) ,Pcrit从 ( 3 2± 0 6)cmH2 O降低为 ( 2 0± 0 8)cmH2 O(P <0 0 5 )。结论 Pcrit能从功能上反映SAHS患者上气道的塌陷程度及病情严重程度 ;
Objective To elucidate the relationship between the pharyngeal critical pressure (Pcrit) and severity in patients with sleep apnea/hypopnea syndrome(SAHS) to recommend therapies for the SAHS patients Methods A total of 165 males(33 served as the control) were checked with polysomnography individually The maximal inspiratory flow and pressure were determined in the other 132 male SAHS patients divided into S 1, S 2, S 3NO CPAP, S 3CPAP according to AASM Task Force (1999) by using the forced oscillation technique (FOT), and then Pcrit was obtained based on the relationship between the flow and the pressure, representing the extrapolated pressure at zero flow by graph The technique of radiofrequency tissue volume reduction (RFTVR) was employed for the treatment of 14 male patients with SAHS Results Pcrit was (1 2±0 6) cm H 2O in S 1, (1 7±0 8) cm H 2O in S 2, (2 2±0 8) cm H 2O in S 3NOCPAP, and (2 6±0 7) cm H 2O in S 3CPAP Obstructive apnea index (OAI) and mixed apnea index (MAI) were significantly higher than obstructive hypopnea index (OHI) in S3CPAP group ( t =7 464, P <0 01, and t =3 718, P <0 01) while the OAI was also very significantly higher than that in S3NOCPAP group ( t =3 804, P <0 01) RFTVR therapy in tongue root decreased upper airway resistance from (6 38±1 46) cmH 2O·L -1 ·S -1 to (4 58±1 57) cm H 2O·L -1 ·S -1 ( P <0 05) and Pcrit from (3 2±0 6)cm H 2O to (2 0±0 8)cmH 2O ( P <0 05) Conclusion Pcrit can be used to estimate the severity of the upper airway collapsibility in patients with SAHS diagnostically The features of the severe SAHS patients submitted to CPAP (S 3CPAP group) are the higher the Pcrit is, the more severe the upper airway collapsibility, obstructive and mixed apnea and hypoxemia are The RFTVR therapy in tongue root can significantly decrease the Pcrit, diminish the upper airway collapsibility and boost the compliance with CPAP in SAHS patients
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2003年第16期1484-1487,共4页
Journal of Third Military Medical University
关键词
睡眠呼吸暂停低通气综合征
临界压
持续正压通气治疗
射频组织缩积术
咽部塌陷
sleep apnea/hypopnea syndrome
pharyngeal critical pressure
continuous positive airway pressure
radiofrequency tissue volume reduction
