睡眠呼吸暂停综合征患者的持续气道正压通气治疗压力预测  

Relationship of continuous positive airway pressure and pulmonary function in patients with obstructive sleep apnea-hypopnea syndrome

作　　者：韩建芳[1] 李涛平[1] 冯媛[1] 李丹青[1] 李晓琳[1] 罗淼[1] 

机构地区：[1]南方医科大学南方医院睡眠医学中心,广东广州510515

出　　处：《南方医科大学学报》2012年第12期1727-1729,共3页Journal of Southern Medical University

基　　金："十二五"国家科技支撑计划(2012BAI05B03);广东省科技计划项目(2011B090400378)~~

摘　　要：目的探讨睡眠呼吸暂停低通气综合征患者持续气道正压通气治疗压力与其肺功能指标的关系,并简易预测有效的治疗压力公式。方法回顾性分析48例确诊为OSAHS患者的临床资料,并行肺功能测定和人工气道压力滴定。观察指标包括治疗压力和肺功能指标(潮气量、一秒量、中心气道阻力、外周气道阻力等)。行多元线性回归分析。结果睡眠呼吸暂停低通气综合征患者的治疗压力与肺功能各项指标无相关关系,与颈围、腹围、睡眠呼吸暂停低通气指数、平均血氧饱和度、最低血氧饱和度、氧降指数有相关关系。根据多元线性逐步回归(按α=0.05检验水准),只有氧降指数(P=0.002)和平均血氧饱和度(P=0.034)两个变量进入以治疗压力为应变量的回归方程中,且有统计学意义。即治疗压力与氧降指数及平均血氧饱和度有线性回归关系,与平均血氧饱和度呈负相关。结论睡眠呼吸暂停低通气综合征患者的治疗压力与肺功能无相关关系。预测公式为:有效治疗压力=24.262+0.044×氧降指数-0.19×平均血氧饱和度,在无人工压力滴定的条件下可以通过此公式预测治疗压力。Objective To explore the relationship of continuous positive airway pressure and pulmonary function in patients with obstructive sleep apnea hypopnea syndrome （OSAHS）, and formulate the prediction equation for the effective therapeutic pressure. Methods In a retrospective cross-sectional study of 48 patients with established OSAHS, all the patients were carefully examined for their medical history, and overnight sleep monitoring was carried out to measure the sleep apnea-hypopnea index, mean oxygen saturation, minimum oxygen saturation, and oxygen drop index. The data of manual pressure titration （effective pressure） and pulmonary function tests （tidal volume, one second forced expiratory volume, central airway resistance, and peripheral airway resistance were collected for multiple linear regression analysis. Results The effective therapeutic pressure was not correlated with the indices of the pulmonary functions in the patients, but showed correlations with the neck circumference, abdominal circumference, apnea-hypopnea index, mean oxygen saturation, least oxygen saturation, and oxygen desaturation index. Multiple linear regression （a--0.05 test level） identified only oxygen desaturation index （P=0.012） and mean oxygen saturation （P=0.036） as the dependent variables of the effective therapeutic pressure. Linear regression analysis showed that the effective therapeutic pressure had a linear relationship with the oxygen drop index and mean oxygen saturation, and was inversely correlated with the mean oxygen saturation. Conclusions In patients with OSAHS, the pulmonary function indices are not correlated with the effective therapeutic pressure. In the absence of manual pressure titration, the effective therapeutic pressure can be predicted using the prediction equation： effective therapy pressure = 24.262＋0.044×oxygen desaturation index -0.19×average oxygen saturation.

关 键 词：睡眠呼吸暂停低通气综合征 治疗压力 肺功能 预测公式 

分 类 号：R766[医药卫生—耳鼻咽喉科]