脉冲强迫振荡测定值在睡眠呼吸暂停综合征中的变化及其临床意义

The change and its signifcance of measurement value of Impulse Oscillometry in obstructive spleep apenea syndrome patients

目的 观察脉冲强迫振荡 (IOS)测定值在阻塞性睡眠呼吸暂停综合征 (OSAS)患者中的变化 ,并探讨其临床意义。方法 用IOS技术检测 3 6例OSAS患者、14例慢性阻塞性肺疾病(COPD)患者和 12名正常人呼吸阻抗 ,同时进行睡眠监测。结果 OSAS患者R2 0 明显高于COPD组和对照组 ,差异有非常显著性 (P <0 .0 1) ,R5～R2 0 虽低于COPD组 ,但仍高于对照组 ,差异亦有非常显著性 (P <0 .0 1)。将OSAS患者睡眠监测指标与IOS测定指标相关性进行研究 ,发现呼吸暂停低通气指数 (AHI)与R5和R2 0 呈正相关 ,相关系数 (r)分别为 0 .66和 0 .86(P <0 .0 1) ;最低SO2 与R5、R5～R2 0 呈负相关 ,r分别为 -0 .66和 -0 .79(P <0 .0 1) ;平均SO2 与R5、R5～R2 0 呈负相关 ,r分别为 -0 .81和 -0 .69(P <0 .0 1)。结论 IOS技术可作为用于检测OSAS患者上气道阻力的一种方法 ,并且有助于其病理机制的探讨。

Objective To observe the change of measurement value of Impulse Oscillometry in OSAS patients and to explore its meaning.Methods The respiratory impedance were measured by using IOS technique and polysomnography(PSG) were done synchronously in 36 OSAS patients,14 COPD patients and control group(12 normal subjects).Results R 20 in OSAS group was significantly higher than those in COPD group and control group( P <0.01).R 5 R 20 in OSAS group was still significantly higher than that in control group( P <0.01),although it was lower than that in COPD group.AHI correlated with R 5 and R 20 ,with correlation index ( r ) 0.66 and 0.86,respectively.The lowest SO 2 was correlated with R 5 and R 5～R 20 ,with r -0.66 and -0.79,respectively.The mean SO 2 was correlated with R 5 and R 5 R 20 ,with r -0.81 and -0.69,respectively.Conclusion IOS technique is a valuable tool for assessing the degree of upper airway obstruction in patients with OSAS,and can help to explore its pathological mechanism.