肺容量与阻塞性睡眠呼吸暂停低通气综合征关系的研究  

Correlation between lung volume and the severity of obstructive sleep apnea hypopnea syndrome in obese patients

作　　者：杨荣刚[1] 叶京英[2] 张玉焕[2] 王杨 曹鑫[2] 张俊波[2] 

机构地区：[1]贵阳中医学院第二附属医院耳鼻咽喉头颈外科,550003 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科 [3]呼吸科

出　　处：《中华耳鼻咽喉头颈外科杂志》2013年第4期295-299,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然基金（30973295）;北京市教育委员会科技计划重点项目（KZ201010025020）

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）病情严重程度与肺容量及肥胖的关系。方法经多道睡眠图监测确诊的53例男性肥胖OSAHS患者，行肺功能检查，测量患者的肺容量指标：最大肺活量（maximum vital capacity，VCmax）、用力肺活量（forced vital capacity，FVC）、最大通气量（maximum voluntary ventilation，MVV）、功能残气量（functionalresidual capacity，FRC）及肺总量（total lung capacity，TLC），并进行各肺容量值与呼吸暂停低通气指数（AHI）、最低动脉血氧饱和度（LSaO：）、平均动脉血氧饱和度（MSaO：）及体质量指数（BMI）的相关性分析。结果男性肥胖OSAHS患者的AHI与动态肺容量FVC、MVV和VCmax呈负相关趋势（r值分别为一0．533、一0．276和一0．575，P值〈0．05或〈0．01），LSa02与FVC、MVV、VCmax呈正相关趋势（r值分别为0．299、0．435和0．412，P值〈0．05或〈0．01），MSa02与FVC、MVV、VCmax也呈正相关趋势（r值分别为0．344、0．474和0．457，P值〈0．05或〈0．01）。OSAHS患者的BMI与AHI呈正相关关系（r=0．728，r2=0．530，P〈0．01），与LSa02、MSa02、FVC、MVV、VCmax呈负相关趋势（r值分别为-0．519、-0．583、-0．312、-0．328和-0．331，P值〈0．05或〈0．01）。静态肺容量FRC和TLC与AHI、LSaO2、MSaO2及BMI均无相关关系（P值均〉0．05）。结论肥胖、动态肺容量与OSAHS之间存在相关趋势，OSAHS病情严重程度可能与肥胖引起动态肺容量减少有关。Objective To examine the relationship between the severity of obstructive sleep apnea hypopnea syndrome （ OSAHS）, lung volume and obesity. Methods The study included 60 adult male obese patients with OSAHS determined by overnight polysomnogram （PSG） using American Academy of Sleep Medicine-defined criteria. Lung volume measurements were made in maximum vital capacity （ VCmax）, forced vital capacity （FVC） , maximum voluntary ventilation （ MVV ） , functional residual capacity （FRC） and total lung capacity （TLC）. Results The aponea hypopnea index（AHI） were negatively correlated with FVC, MVV, VCmax （r were -0. 533, -0. 276 and -0. 575, P 〈0. 01 or P 〈0. 05 ）. But the lowest arterial oxygen saturation （LSaO2 ） and the mean arterial oxygen saturation （MSaO2 ） were positively correlated with FVC, MVV and VCmax （ r were 0. 299, 0. 435,0. 412, and O. 344, 0. 474, 0. 457, P 〈 0. 01 or P 〈 0. 05 ）. The body mass index （BMI） were positively correlated with AHI （r = 0. 728, r2 = 0. 530, P 〈0. O1 ）. The FVC, MVV, VCmax, LSaO2 and MSaO2 varied inversely with BMI. FRC and TLC had no relation with AHI, LSaO2, MSaO2 and BMI. Conclusions There are significant correlations among obesity, dynamic lung volume and OSAHS severity. This result suggests that changes in dynamic lung volume may play an important role in the pathogenesis of OSAHS in obese patients.

关 键 词：睡眠呼吸暂停 阻塞性 肺容量测定 肥胖症 

分 类 号：R766[医药卫生—耳鼻咽喉科]