阻塞性睡眠呼吸暂停低通气综合征患者运动心肺功能的研究  

The change and significance of the cardiopulmonary exercise test parameters in patients with obstructive sleep apnea-hypopnea syndrome

作　　者：潘文森[1] 袁雅冬[1] 张鲁涛[1] 郝树亭[1] 杨红申[1] 王保法[1] 马俊义[1] 

机构地区：[1]河北医科大学第二医院呼吸内科,石家庄050000

出　　处：《中华结核和呼吸杂志》2005年第11期769-772,共4页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者运动心肺功能的改变及其可能机制。方法OSAHS患者30例为试验组,健康男性18名为对照组。受试者进行心肺运动试验(CPET),测定最大摄氧量占预计值百分比(.Vo2m ax占预计值%)、摄氧量功率比值(.VO2/WR)、氧脉搏占预计值百分比(.Vo2/HRm ax占预计值%)、无氧阈与最大摄氧量比值(AT/.Vo2m ax)、二氧化碳通气当量(.VE/.VCO2)及呼吸储备(V.Objective To investigate the change of exercise cardiopulmonary function in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods Thirty OSAHS patients and 18 normal healthy adults（ control group） were studied by cardiopulmonary exercise test（CPET）. The results including maximal oxygen uptake percent predicted （ V^·o2 max% predicted） , oxygen uptake to work rate（ V^·o2/ WR） ,oxygen pulse percent predicted（V^·o2/HRmax% predicted）, anaerobic threshold to maximal oxygen uptake（AT/V^·o2max） ,breathing reserve（V^·Emax/MVV） and ventilatory equivalents for carbon dioxide（ V^·E/V^·CO2 ） were compared between two groups. Results The levels of V^·o2max% predicted,AT/V^·o2max,V^·o2/ HRmax% predicted,V^·o2/WR, and V^·Emax/MVV in the OSAHS group [ （ 83 ± 5 ） %, （ 44 ± 6 ） %, （ 79 ± 5）% ,（9.3 ±0. 6） ml · min^-1· W^-1, （73 ± 8）% ] were lower than those in the control group[ （88 ± 5）% ,（49 ±6）% ,（83 ±4）% ,（ 10.9 ±2.3） ml · min^-1· W^-1 ,（79 ±9）% ,all P 〈0.05]. The levels of V^· E/V^·CO2 in the OSAHS group（ 29 ± 3 ） was higher than the control group（ 26 ± 3, P 〈 0.05 ）. In the OSAHS group V^·o2max% predicted,V^· o2/HRmax% predicted, V^·o2/WR AT/V^· o2max and V^·Emax/MVV correlated negatively with apnea-hyponea index（ AHI, r = - 0.52, - 0.62, - 0.59, - 0.37, - 0.66, P 〈 0.05 ）. V^· 02 max% predicted, V^· o2/HRmax% predicted, V^·o2/WR, AT/V^·o2 max and V^·E max/MW correlated with lowest oxygen saturation（ LSaO2, r = 0. 60,0. 63,0. 64,0. 40,0. 59, P 〈 0.05 ）. V^·E/V^·CO2 correlated with AHI（ r = 0.57,P 〈 0.01 ） and correlated negatively with LSaO2 （ r = - 0.62,P 〈 0.01 ）. Conclusions The cardiac output of patients with OSAHS can not meet the demand of hard exercise. At the same time,there is more significant ventilation-perfusion disturbance in OSAHS patients than normal subjects. The patients＇ exercise cardiopulmonary function has been compromized although the

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 心脏功能试验 呼吸功能试验 运动试验 心排出量 通气与血流灌注比值 

分 类 号：R56[医药卫生—呼吸系统]