不同严重程度的阻塞性睡眠呼吸暂停低通气综合征患者的肺功能分析

目的研究不同严重程度的阻塞性睡眠呼吸暂停低通气综合征患者的肺功能变化。方法选取于我院因打鼾、白天嗜睡、夜间呼吸暂停就诊的患者,共184例,所有人均行肺功能、多导睡眠图(PSG)检查,根据呼吸暂停低通气指数(AHI)分为4组:对照组49例(AHI<5)、轻度组37例(5≤AHI<15)、中度组43例(15≤AHI<30)、重度组55例(AHI≥30)。分析各组肺活量(VC)实/预、补呼气量(ERV)、功能残气量(FRC)、第1秒呼气量(FEV 1)实/预、1秒率(FEV 1/FVC%)、最大呼气中期流速(MMEF)实/预%、50%肺活量流速(FEF 50%)实/预%、75%肺活量流速(FEF 75%)实/预%、肺总量(TLC)实/预、一氧化碳弥散量(TLCO)实/预%、最大自主通气量(MVV)、残气量/肺总量(RV/TLC)等指标。结果重度组MMEF实/预%、FEF 50%实/预%、FEF 75%实/预%、ERV、FRC明显低于中度组,中度组上述指标较轻度组降低,轻度组低于对照组,差异均有显著的统计学意义(P<0.05),而VC实/预%、FEV 1实/预%、FEV 1/FVC%、TLC实/预%、DLCO实/预%、RV/TLC%、MVV各组之间差异无统计学意义(P>0.05);此外MMEF实/预%、FEF 50%实/预%、FEF 75%实/预%与AHI、LAT呈负相关,与LSaO 2呈正相关;ERV、FRC与BMI呈负相关。结论OSAHS患者存在小气道功能损害,且其受损程度与夜间睡眠紊乱程度呈正相关。

Analysis of pulmonary function in patients with different severity of obstructive sleep apnea hypopnea syndrome

Objective To study the changes in lung function of patients with obstructive sleep apnea hypopnea syndrome of different severity.Methods A total of 184 patients with snoring,daytime sleepiness and nighttime apnea in our hospital were selected.All patients were examined by pulmonary function and polysomnography(PSG).They were divided into 4 groups according to the apnea hypopnea index(AHI):49 patients in the control group(AHI<5),37 patients in the mild group(5≤AHI<15),43 patients in the moderate group(15≤AHI<30),and 55 patients in the severe group(AHI≥30).Those indexes were analyzed,including ERV,FRC,FEV 1/FVC,MVV,RV/TLC,VC/pre,MMEF/pre,FEF 50%/pre,FEF 75%/pre,TLC/pre,and TLCO/pre.Results The value of MMEF/pre,FEF 50%/pre,FEF 75%/pre,ERV(L)and FRC(L)in the severe group were significantly lower than those in the moderate group,followed by the mild group and the control group(P<0.05),and there was no significant difference in VC/pre,FEV 1/pre,FEV 1/FVC%,TLC/pre,DLCO/pre,RV/TLC%or MVV(P>0.05).In addition,MMEF/pre,FEF 50%/pre,and FEF 75%/pre had a negative correlation with AHI and a positive correlation with LSaO 2,and ERV and FRC had a negative correlation with BMI.Conclusion There is small airway dysfunction in patients with OSAHS,and the degree of damage is positively correlated with the degree of nocturnal sleep disturbance.