阻塞性睡眠呼吸暂停综合征患者气道阻力与脉压变化的关系

Changes of airway resistance and pulse pressure in patients of sleep apnea-hypopnea syndrome

目的探讨睡眠呼吸暂停低通气综合征（OSAHS）患者气道阻力、脉压的变化及其关系。方法选择OSAHS患者31例、健康者10人（对照组），均采用多导睡眠图仪（PSC）监测，同时应用肺功能仪及脉冲强迫振荡技术监测其气道阻力，且在PSG监测前后及期间每2小时测量其血压，计算出脉压、平均收缩压及平均舒张压。结果中重度OSAHS患者V50、V25、R5、R20、R5-R20、R35以及脉压值均明显高于轻度OSAHS患者和对照组；重度OSAHS患者平均收缩压、平均舒张压均明显大于对照组。而VCmax、FEV1／FVC、FEV1、PEF值在各OSAHS与对照组比较差异无显著性。相关分析结果表明，呼吸紊乱指数与R5、R20、R5～R20、R35、脉压、平均收缩压、平均舒张压呈正相关，与V50、V75、平均氧饱和度、最低氧饱和度呈负相关，与VCmax、FEV1／FVC、FEV1、PEF无相关。PP与R5、R5～R20、R35呈正相关，而与R20无相关。结论OSAHS患者气道阻力及脉压均增大，并与OSAHS病情严重程度密切相关。

Objective To investigate the changes of airway resistance and pulse pressure in patients of obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods 31 case of OSAHS and 10 case of normal subjects were examed by polysomnography, blood pressure monitor apparatus, pulmonary function apparatus and forced oscillation technique. Results The values of V50, V25, R5, R20, R5- R20, R35 ,pulse pressure in moderate and severe patients of OSAHS were higher than those in mild patients of OSAHS and control group. Mean systolic and diastolic blood pressure in severe patients of OSAHS were higher than those in control group. The values of VCmax, FEV1, FEV1/FVC and PEF were no significant difference between all OSAHS and control group. There were positive correlations between AHI and R5 , R20, R5-R20, R35, pulse pressure, mean systolic and diastolic blood pressure, but negative correlations between AHI and V50, V75, the minimum and the mean value of SPO2. Forthemore there were no correlations between AHI and VCmax, FEV1, FEV1/FVC. Eventully, there were positive correlations between pulse pressure and R5, R5 - R20 or R35, but no correlation between pulse pressure and R20, Conelusion It is indicated that airway resistance and pulse pressure were higher,which were associated with serious degree of disease in patients of OSAHS.