特发性肺纤维化患者中的睡眠呼吸暂停及其临床意义

目的观察阻塞性睡眠呼吸暂停低通气综合征（OSAHS）在特发性肺纤维化（IPF）患者中的发病率及临床意义。方法采用多导睡眠图监测20例IPF患者睡眠质量及呼吸紊乱情况,分析其与肺功能之间的关系。结果 20例IPF患者中有13例（65%）合并有OSAHS,其中轻度OSAHS3例（15%）,中重度OSAHS 10例（50%）。IPF患者睡眠效率、快眼动睡眠（REM）及慢波睡眠比例降低,微觉醒指数增加。相关分析显示呼吸暂停低通气指数（AHI）与体重指数（BMI）呈正相关（r=0.791,P〈0.0001）,与用力肺活量占预计值百分比（FVC%pred）（r=-0.672,P=0.001）及第1秒用力呼气容积占预计值百分比（FEV1%pred）（r=-0.659,P=0.002）呈负相关。结论 OSAHS在IPF患者中普遍存在,尽早治疗IPF患者合并的OSAHS可能会有利于改善生活质量及预后。

Sleep Apnea in Idiopathic Pulmonary Fibrosis

Objective To investigate the prevalence of obstructive sleep apnea hypopnea syndrome（OSAHS） in patients with idiopathic pulmonary fibrosis （IPF） and its clinical significance.Methods Sleep quality and breathing disorders were measured by polysomnography and the relationship with lung function was analyzed in 20 IPF patients.Results Thirteen of 20 subjects（65%） had OSAHS as defined by an AHI ≥5 events per hour.Three subjects（15%） had mild OSAHS（AHI,5 to 20 events per hour）,and 10 subjects（50%） had moderate-to-severe OSAHS（AHI≥20 events per hour）.The sleep architecture in these patients showed a reduction in sleep efficiency,rapid eye movement（REM） sleep and slow wave sleep,and a marked sleep fragmentation due to an increased arousal index.The AHI was negatively correlated with FVC%pred（r=-0.672,P=0.001） and FEV1%pred（r=-0.659,P=0.002）,and positively correlated with body mass index（BMI）（r=0.791,P0.0001）.Conclusions OSAHS is a common comorbidity in IPF.Early treatment of OSAHS may improve quality of life and the prognosis of patients with IPF.