阻塞性睡眠呼吸暂停低通气综合征病人运动心肺功能与病情及预后的相关性

Correlation of exercise cardiopulmonary function and severity and prognosis 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)病人运动心肺功能与病情及预后的相关性。方法 66例OSAHS病人根据呼吸暂停低通气指数(AHI)分为轻中度组41例、重度组25例,并选择同期单纯打鼾者30例作为对照组。分析OSAHS病情严重程度和静态心肺功能及运动心肺功能的相关性。结果与对照组比较,轻中度组、重度组深吸气量(IC)、残总百分比(RV/TCL)均显著降低,残气量(RV)显著升高(P<0.05),而1秒用力呼气容积占预计值(FEV1%)、1秒用力呼气容积占用力肺活量比值(FEV1/FVC)在对照组与轻中度组之间差异无统计学意义(P>0.05);各静态肺功能指标在轻中度组和重度组之间比较,差异有统计学意义(P<0.05);与对照组比较,OSAHS组最大摄氧量占预计值百分比(VO_2max%pred)、最大摄氧量峰值占预计值百分比(peak VO_2%pred)、氧脉搏占预计值百分比(peak O_2pulse)、摄氧量功率比值(VO_2/WR)、无氧阈值(AT)、二氧化碳通气当量(VE/VCO_2)明显降低,VE/VCO_2明显升高(P<0.05);呼吸暂停低通气指数(AHI)与peak VO_2%pred、peak O_2pulse、AT、呼吸储备(VEmax/MVV)呈负相关,与VE/VCO_2呈正相关(P<0.05)。结论运动心肺功能可反映OSAHS病人的心肺功能及病情的严重程度,可作为早期监测指标并指导治疗,评估预后。

Objective To explore the correlation of exercise cardiopulmonary function and severity and prognosis of obstructive sleep apnea-hypopnea syndrome（ OSAHS） . Methods According to the AHI,66 patients with OSAHS who were admitted in our hospital were divided into two groups,including 41 patients of mild-to-moderate group,25 patients of severe group and 30 patients with snoring were also selected as control group. The correlation of severity with static and exercise cardiopulmonary function in OSAHS was analyzed. Result Compared with snoring group, FEV1 % pred,IC,RV/TLC in mild-to-moderate group,severe group were significantly reduced, and RV was significantly increased （P 〈 0 .0 5 ） ,whereas there were no significant difference on FEV1/FVC,TLC between snoring and mild-to-moderate group （P 〈0. 0 5 ） . The difference on static lung function indicators between mild-to-moderate group and severe group had statistical significance （P〈0. 05）. Compared with snoring group, VO2max% pred, peakV02% pred, peak02pulse, VO2/WR , AT, VEmax/MVV in OSAHS group was significantly reduced and VE/VC02 was increased significantly （P 〈 0 .0 5 ） . AHI was negatively correlated with peak V02%pred, peak02pulse, AT, VEmax/MVV and positively correlated with VE/VC02（ P 〈 0 .0 5 ） . Conclusions Exercise cardiopulmonary function could reflect the cardiopulmonary function and severity of patients with OSAHS and can be used as early monitoring indicators and to guide treatment and assessing prognosis.