多导睡眠监测仪在不同程度阻塞性睡眠呼吸暂停低通气综合征合并哮喘中的应用  

Application of polysomnography monitor in different degrees of OSAHS complicated with asthma

作　　者：王彩彩[1] 唐茜 王红景 崔立静 孟静[1] 李艳君[1] 王亮[1] 王媛 WANG Cai-cai;TANG Qian;WANG Hong-jing(The Third Department of Respiratory and Critical Care,Hebei Chest Hospital,Shijiazhuang 0500000,China;不详)

机构地区：[1]河北省胸科医院呼吸与危重症三科,河北石家庄050000 [2]河北省胸科医院呼吸与危重症二科,河北石家庄050000

出　　处：《中国医学装备》2023年第3期103-108,共6页China Medical Equipment

基　　金：河北省医学科学研究课题计划(20180650)“哮喘合并阻塞性睡眠呼吸暂停低通气综合征96例临床研究”。

摘　　要：目的:探究多导睡眠监测仪用于评估不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并哮喘的应用。方法:选取医院收治的96例OSAHS合并哮喘患者,将其纳入观察组,选取同期40名在医院进行健康体检受检者将其纳入健康对照组。收集两组临床基本资料,所有入组者均行心电监护仪监测、踏车运动方案检测、经皮二氧化碳试验检测及多导睡眠监测,并对比各项指标变化。结果:观察组体质量指数(BMI)、舒张压、收缩压、腰围及高密度脂蛋白(HDL)水平均高于健康对照组,甘油三酯(TG)水平低于健康对照组,差异均有统计学意义(t=9.386,t=3.621,t=4.160,t=6.412,t=4.059,t=5.064;P<0.05)。观察组轻度、中度及重度的OSAHS患者合并哮喘患者平均动脉压(MAP)、二氧化碳分压(PaCO_(2))及碳酸氢根离子(HCO_(3)-)水平逐渐升高,脉搏血氧饱和度(SpO_(2))及动脉血氧分压(PaO_(2))水平均逐渐降低,与健康对照组比较差异均有统计学意义(F=52.97,F=122.75,F=426.95,F=218.79,F=21.58;P<0.05)。观察组不同程度OSAHS患者最大摄氧量(VO_(2max))、最大呼吸储备(VE_(max))、最大摄氧量峰值(VO_(2peak))、摄氧功率比值(VO_(2)/WR)及无氧阈值(AT)水平呈下降趋势,二氧化碳通气当量(VE/VCO_(2))水平呈升高趋势,与健康对照组比较差异均有统计学意义(F=74.38,F=124.25,F=119.80,F=172.18,F=183.89,F=196.06;P<0.05)。观察组不同程度OSAHS患者最高经皮二氧化碳分压(HTcPCO_(2))、最低经皮二氧化碳分压(LTcPCO_(2))及平均经皮二氧化碳分压(MTcPCO_(2))水平呈显著增加趋势,与健康对照组比较差异均有统计学意义(F=1470.74,F=297.74,F=330.10;P<0.05)。观察组不同程度OSAHS患者血氧饱和度(SaO_(2))<90%持续时间逐渐延长,睡眠呼吸暂停低通气指数(AHI)及微觉醒指数水平明显增加,最低血氧饱和度(LAST)水平明显降低,与健康对照组比较差异均有统计学意义(F=192.46,F=317.13,F=93.39,F=107.02;P<0.05)。�Objective:To explore the application of polysomnography monitor in the assessment of different degrees of obstructive sleep apnea-hypopnea syndrome(OSAHS)that complicated with asthma.Methods:A total of 96 patients with OSAHS complicated with asthma who admitted to hospital were selected as the observation group,and 40 persons who underwent physical examination in hospital during the same period were selected as the healthy control group.The clinically basic data of all patients were collected.All patients were monitored by ECG monitor,treadwheel exercise program,percutaneous carbon dioxide test and polysomnography monitoring,and the changes of various indicators were compared.Results:The levels of body mass index(BMI),diastolic blood pressure,systolic blood pressure,waist circumference and high-density lipoprotein(HDL)in the observation group were significantly higher than those in the healthy control group,respectively,and the TG level of the observation group was significantly lower than that in the healthy control group(t=9.386,t=3.621,t=4.160,t=6.412,t=4.059,t=5.064,P<0.05).In observation group,with the increasing of the degree of OSAHS complicated with asthma from mild to middle,and from middle to severe degree,the levels of mean arterial pressure(MAP),partial pressure of carbon dioxide(PaCO_(2))and bicarbonate radical ion(HCO_(3)-)gradually increased,and the saturation of pulse oximetry(SpO_(2))and arterial partial pressure of oxygen(PaO_(2))gradually decreased,and the differences of them between two groups were significant(F=52.97,F=122.75,F=426.95,F=218.79,F=21.58,P<0.05),respectively.In observation group,the levels of maximum oxygen uptake(VO_(2max)),the maximum respiratory reserve(VE_(max)),the maximum oxygen uptake peak(VO_(2peak)),the ratio of oxygen uptake power(VO_(2)/WR)and the threshold value of oxygen free of patients appeared declining trend with the change of different degrees,while the levels of ventilation equivalent of carbon dioxide(VE/VCO_(2))appeared rising trend,which were significantly

关 键 词：多导睡眠监测仪 阻塞性睡眠呼吸暂停低通气综合征(OSAHS) 哮喘 

分 类 号：R256.12[医药卫生—中医内科学]