阻塞性睡眠呼吸暂停低通气综合征患者呼吸阻抗的测定

目的　探讨阻塞性睡眠呼吸暂停低通气综合征 (OSAHS)患者呼吸阻抗的特征和临床意义。方法　测定并分析 5 2例OSAHS患者、13例COPD患者、17例健康人多导睡眠图 (PSG)、脉冲振荡法 (IOS)指标。结果　⑴OSAHS组总呼吸阻抗、中心气道阻抗、R2 0明显高于正常对照组 (P <0 0 5 ) ;响应频率、外周气道阻抗、R5、R5 -2 0、X5、X3 5与正常对照组无显著差异 (P >0 0 5 )。⑵OSAHS组响应频率、总呼吸阻抗、外周气道阻抗、R5、R5 -2 0明显低于COPD组 (P <0 0 1)。⑶OSAHS患者SaO2 与总呼吸阻抗、中心气道阻抗、R5、R2 0呈负相关 (P <0 0 1) ,AHI与总呼吸阻抗、中心气道阻抗、R5、R2 0呈正相关 (P <0 0 1)。结论　OSAHS患者IOS表现为上气道阻力升高 ,并与病情程度相关。

A Study on Respiratory Impedance of Patients with Obstructive Sleep Apnea-hypopnea Syndrome

Objective To investigate the characteristics of respiratory impedance in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods The impulse oscillometry(IOS) and polysomnography (PSG) indices were measured in 52 patients with OSAHS, 13 patients with chronic obstructive pulmonary disease (COPD) and 17 healthy persons. Results The levels of R20, total respiratory impedence and central airway resistance in the patients with OSAHS were significantly higher than those in healthy persons (P<0.05). The levels of R5, R5-20, resonance frequency, total respiratory impedence and peripheral airway resistance in the patients with OSAHS were significantly lower than those in the patients with COPD (P<0.01). The levels of R20, R5, total respiratory impedence and central airway resistance were negatively correlated with SaO 2, and the levels of R5, R20, total respiratory impedence and central airway resistance were positively correlated with apnea-hyponea index (AHI). Conclusion IOS could serve as a distinctive index for the study of respiratory impedance in the patients with OSAHS.