阻塞性睡眠呼吸暂停低通气综合征超重者减重前后分析  

Study on weight loss in 52 obese patients with obstructive sleep apnea hypopnea syndrome

作　　者：顾建华[1] 陆甘[1] 顾刘宝[2] 

机构地区：[1]江苏省老年医院呼吸科,江苏省南京市210024 [2]江苏省老年医院内分泌科,江苏省南京市210024

出　　处：《实用老年医学》2006年第1期40-42,共3页Practical Geriatrics

摘　　要：目的探讨降低体质量对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）伴超重或肥胖者的影响及临床意义。方法采用低热量饮食（84～150kJ／kg）和（或）运动减重后，观察52例OSAHS伴超重或肥胖者减重前后自体症状、睡眠监测及血液生化等各项指标的变化情况。结果52例患者减重后鼾声、嗜睡评分、憋气、憋醒、记忆力下降、全身不适、胸闷、心悸症状均有改善。颈围、腰围、臀围明显缩小；呼吸暂停次数、呼吸暂停低通气指数（AHl）、呼吸暂停指数（AI）明显减少（P〈0．01）。低通气指数（HI）无明显变化。血氧饱和度（SaO2）〈95％及〈85％所占的时间百分比明显减少，最低血氧饱和度（LSaO2）明显升高。最长呼吸暂停时间明显缩短．红细胞计数（RBC）、血红蛋白（HB）、红细胞压积（HCT）、三酰甘油（TG）、总胆固醇（TC）、血尿酸（uA）明显降低。结论减重对OSAHS伴超重或肥胖者的治疗是有效的，可使OSAHS者的严重程度得到改善，并使部分轻度OSAHS治愈。减重后缺氧、RBC、血脂的改善对预防心脑血管疾病非常有益。Objective To observe the effects and clinic significance of weight loss on obese or overweight patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Methods After weight loss through low-calorie diet （84 ～ 105 kJ/kg） and （or） physical exercise, the symptoms, sleep monitoring and blood biochemical parameters of 52 patients were recorded. Results After weight loss treatment,52 patients had obvious improvement in the snoring, sleepiness score,apnea,arousal, declined memory, general malaise, chest distress and palpitation. Neckline, waistline and hipline decreased significantly. Apnea times, respiratory apnea hypopnea index （ AHI ） and respiratory apnea index （ Al ） dropped as well （ P 〈 0. 01）. Hypopnea index（HI） had not significant difference. The time when SaO2 was lower than 95% and 85% was decreased. The minimal SaO2 increased,and the longest apnea time deceased. The level of red blood cell（RBC） , hemoglobin （ HB）, hemocrit of RBC （ HCT）, blood triglyeeride （ TG）, total cholesterol （ TC ） and uric acid （ UA ） declined. Conclusions Weight loss is effective for obese or overweight patients with OSAHS. It may improve severity of the patients. Some mild patients can recover completely. It is also beneficial for eerebrocardiovascular diseases by improving hypoxia, RBC count and blood lipid.

关 键 词：减重 阻塞性睡眠呼吸暂停综合征 肥胖 

分 类 号：R563.9[医药卫生—呼吸系统]