不同程度阻塞性睡眠呼吸暂停低通气综合征患者气道呼吸阻力测定的临床研究

Respiratory Resistance in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome with Different Apnea-Hypopnea Indexes

目的研究不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者气道呼吸阻力的差异。方法选取确诊为OSAHS且常规肺功能检查正常的35例患者进行研究,依呼吸紊乱指数(AHI)将其分为轻度(5次/h≤AHI≤20次/h)、中重度(AHI>20次/h)两组,研究两组患者气道呼吸阻力的相互关系。结果两组患者在4 Hz及16 Hz振荡频率所反映的总气道阻力及中心气道阻力上,中重度组患者增加更为明显,但两组间差异无统计学意义(P>0.05),而8 Hz振荡频率所反映的周围气道阻力上的差异有统计学意义(P<0.05)。结论 8 Hz振荡频率所反映的周围气道阻力增高更为明显,说明部分OSAHS患者常规肺功能虽无异常,但仍有小气道因素存在。脉冲强迫振荡(IOS)技术对OSAHS的诊断有一定的意义,对于可疑OSAHS的患者,可通过IOS测量联合体质指数、颈围、白天症状等预测整夜多导睡眠图(PSG)可能的异常,减少进行夜间监测的次数。

Objective To investigate the difference of respiratory resistance in patients with obstructive sleep apnea - hypopnea syndrome （OSAHS） with different apnea -hypopnea indexes （AHI） . Methods A total of 35 OSAHS patients with normal lung function test were recruited, and they were divided according to their AHI as mild group （5 〈 AHI ≤20） and meddle - sever group （ AHI 〉20）. Results At 4 Hz and 16 Hz oscillation frequency, the total airway resistance and central airway resistance in the meddle - sever group were severer that those in the mild group, but with no statistical difference （ P 〉 0. 05 ）. However the increase of the peripheral airway resistance at 8 Hz oscillation frequency was the most evident, and the difference between the two groups was statistically significant （ P 〈 0.05 ）. Conclusion The OSAHS patients have increased small airway resistance, even though some of them have no anomaly in pulmonary function. The impulse oscillometry （lOS） technology is of certain significance to diagnosis of OSAHS, so the forecast of possible anomaly in polysomnogram （PSG） may be conducted by lOS measurement combined with body mass index, cervical circumference, and symptoms, reducing the time of monitoring during the night.