阻塞性睡眠呼吸暂停低通气综合征患者呼吸阻抗值变化的意义

Significance of breathing impedance values in the patients of obstructive sleep apnea hypopnea syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼吸阻抗值的变化及临床意义。方法用脉冲振荡技术检测38例OSAHS患者、28例COPD患者和20例健康人的呼吸阻抗值,同时进行多导睡眠图监测。结果 OSAHS患者上气道阻力(R35)、中心气道阻力(R20)明显高于COPD组和对照组,差异有统计学意义(P均<0.05);且共振频率、呼吸总阻抗(Zrs)、中心阻力、R20、R35随OSAHS病情加重呈升高趋势,各组之间差别有统计学意义(P均<0.05);OSAHS患者R35、R20与呼吸暂停低通气指数(AHI)呈正相关(r分别为0.623、0.617,P均<0.05);R35、R20、Zrs与最低指端血氧饱和度呈负相关(r分别为-0.607、-0.591和-0.462,P均<0.05)。结论 OSAHS患者上气道阻力及中心气道阻力升高,且此改变与OSAHS病情严重程度相关。

Objective To discuss the variation and clinical significance of breathing impedance values in the patients of obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods Respiratory impedance values of 38 cases of patients with OSAHS, 28 patients with COPD and 20 cases of healthy persons were detected by means of impulse oscillometry （IOS） ; at the same time, monitoring polysomnography（PSG）. Results In the OSAHS patients group, upper airway re- sistance （R35） and central airway resistance （R20） were obviously superior to COPD patients and healthy persons （P 〈 0.05 ） ; resonant frequency （Fres）, total respiratory impedance （Zrs）, the central resistance （Re）, R20, R35 were in- creased with the severity of OSAHS, there was statistical significance between each group. In OSAHS patients group, R35 and R20 with apnea-hypopnea index （AHI） was positively correlated （Correlation coefficients were 0. 623, 0. 617; P 〈 0.05 ） ; R35, R20, Zrs with the lowest SO： were negatively correlated（ Correlation coefficients were - 0. 607, - 0. 591 and - 0. 462, respectively, P 〈 0.05 ）. Conclusions Impulse oscillometry of OSAHS patients represents the rise of upper air- way and central airway resistance, is related to illness degree.