肥胖低通气综合征

Obesity hypoventilation syndrome

肥胖低通气综合征是指由肥胖导致的日间的慢性通气不足。其发病机制包括睡眠呼吸紊乱，呼吸驱动力减低以及与肥胖相关的呼吸系统受损等，并有显著的发病率和病死率。治疗方法主要包括正压通气、减肥及药物治疗等。但是，由于缺乏：赶规模的研究对各种疗法进行评估，限制了循证推荐治疗的发展进程。针对改善睡眠呼吸紊乱的治疗通常是有效的，但并非所有患者都能够忍受面罩通气，且尽管有效，但清醒状态下的高碳酸血症可能会持续存在。从更长远的角度来说，减肥是可取的，但是缺乏其在治疗肥胖肺通气不足的成功率和持续性的数据。这篇文章主要阐述肥胖低通气综合征的主要机制、临床表现及目前的治疗方案。

Obesity hypoventilation syndrome is the association between obesity and the development of chronic daytime alveolar hypoventilation. This syndrome caused by the a complex interaction between sleep-disordered breathing, diminished respiratory drive and obesity-related respiratory impairment, and is associated with significant morbidity and mortality. Therapy directed toward reversing these abnormalities and to improved daytime breathing, with available treatment options including positive pressure therapy, weight loss, and pharmacological management. However, due to the lack of large-scale, well-designed studies evaluating these various therapies has limited the development of evidence-based treatment recommendations. Although treatment directed toward improving sleepdisordered breathing is usually effective, not all patients tolerate mask ventilation and awake hypercapnia may persist despite effective use. In the longer term, weight loss is desirable, but data on the success and sustainability of this approach in obesity hypoventilation are still insufficient. This abstract outlines the main mechanisms, clinical presentations and current therapy options of the obesity hypoventilation syndrome.