中重度阻塞性睡眠呼吸暂停低通气综合征患者肺功能的研究

Pulmonary Function in Patients with Moderate to Severe Obstructive Sleep Apnea-hypopnea Syndrome

目的 :比较中重度阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)、OSAHS合并慢性阻塞性肺病 (COPD)简称重叠综合征患者的睡眠呼吸紊乱和肺功能变化的特点。方法 :对经多导睡眠呼吸监测仪 (PSG)、肺功能检查仪检查的 5 3例受试者资料进行回顾性分析。结果 :OSAHS组睡眠呼吸暂停低通气指数 (AHI)、最长呼吸暂停时间 (LAT)、最低血氧饱和度(LSaO2 )、平均血氧饱和度 (MSaO2 )与重叠综合征组相比无明显差别 ,但前者肺功能受损程度轻于后者。OSAHS组肺功能受损主要表现为限制性通气功能受损 (5 2 2 % ) ,其次为小气道功能受损 (2 1 7% )和阻塞性通气功能受损 (8 7% ) ;重叠综合征组主要表现在阻塞性通气功能受损 (10 0 % )和小气道功能受损 (10 0 % )。两组患者AHI、LSaO2 与肺功能指标受损之间均无明显相关关系。结论 :OSAHS是一种以气道阻塞为特征的疾病状态。OSAHS患者有不同程度的肺功能受损 ,但睡眠呼吸紊乱严重程度与肺功能减损程度间无线性相关关系。

Objective:To compare the change of pulmonary function and the extent of sleep breath disorder in patients with moderate to severe obstructive sleep apnea-hypopnea syndrome (OSAHS) and in patients with overlap syndrome. Methods: Retrospective analysis was conducted on 53 subjects′ clinical data detected by polysomnography and by pulmonary function test apparatus-sensormedics 6200 respectively. Results:There were no significant differences of the AHI、LAT、LSaO 2 and MSaO 2 between OSAHS patients and overlap syndrome patients(P>0.05). However, the ventilation function injury in patients with overlap syndrome was deeper. The pulmonary dysfunction of OSAHS patients was mainly the restrictive ventilation function (52.2%), the impairment of small airway function (21.7%) and obstructive ventilation function (8.7%) were minor. The pulmonary dysfunction in patients with overlap syndrome resided mainly in the obstructive ventilation function (100%) and the small airway function (100%). There were no significant linear relations between pulmonary function impairment and AHI or LSaO 2. Conclusions:OSAHS is a disease state characterized by the presence of airflow obstruction. The patients with OSAHS showed pulmonary dysfunction at various levels, but no significant linear relation between the extents of the sleep breath disorder and pulmonary function impairment was found.