OSAHS对小气道功能影响的研究  

The pathological effect of obstructive sleep apnea hypopnea syndrome on the respiratory function of small airway

作　　者：顾东升[1] 张志存 张耀庭 刘婷 黄春梅[2] GU Dongsheng;ZHANG Zhicun;ZHANG Yaoting;LIU Ting;HUANG Chunmei(The First People’s Hospital of Huai’an,Nanjing Medical University,Jiangsu,223002,China)

机构地区：[1]南京医科大学附属淮安第一医院耳鼻咽喉头颈外科,江苏淮安223300 [2]江苏省淮安市第一人民医院分院耳鼻咽喉科,223002

出　　处：《中国中西医结合耳鼻咽喉科杂志》2023年第5期353-357,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

摘　　要：目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对患者小气道功能的影响。方法研究对象为50例确诊为OSAHS的患者,另以20例健康人为对照组。所有受试者均行多导睡眠图监测,并在在呼吸室内空气含80%He-20%O2混合物的条件下分别行坐位及仰卧位行肺活量和最大流量/体积曲线测定,以计算小气道功能指标等流量体积(VisoV)和50%用力肺活量处的流量差(ΔVmax50%)。结果与对照组的检测值(5.6±1.7)相比,OSAHS组患者VisoV值(19.1±3.9)显著升高(P=0.000),而ΔVmax50%(27.1±8.0)则较对照组(37.4±2.0)显著降低(P=0.000)。坐位状态下,OSAHS组和对照组FVC均值、FEV1、FEV1/FVC、MMEF25-75、MEF差异均无显著性意义。相比坐位检测值,仰卧位OSAHS患者的此类肺功能指标显著下降。结论OSAHS患者患者小气道功能降低,可能因低肺容量呼吸状态导致小气道闭-开循环频发,诱发气道黏膜炎症和氧化应激反应所致。Objective To investigate the pathological effect of obstructive sleep apnea hypopnea syndrome(OSAHS)on the respiratory function of small airway function.Methods Included in this study were 50 patients diagnosed with OSAHS by PSG(polysomnography),with another 20 healthy persons as control.All these subjects underwent PSG monitor during the period of sleep,while spirometry and maximum flow/volume curves determination were carried out in a respiration chamber with a mixture of 80%He-20%O2 in the room air,determined at a sitting posture and at a supine position respectively,to calculate such functional indexes of small airway as equal volume of flow(VisoV)and the flow difference at 50%forced vital capacity(ΔVmax50%)from these two curves.Results As a result of comparison with the detected value of VisoV(19.1±3.9)in the controlling group,this value(5.6±1.7)in OSAHS group was significantly higher(P=0.000),while its value(27.1±8.0)ofΔVmax50%was significantly lower than that(37.4±2.0)in controlling group(P=0.000).When determined at sitting posture,however,there were no statistically significant differences in the mean of FVC,FVC,FEV1,FEV1/FVC,MMEF25-75,and MEF between OSAHS group and control group,but the values of these pulmonary function indexes decreased significantly as compared with those detected at a sitting posture,when determined at a supine position.Conclusion It might be true that patients with OSAHS will show reduced small airway function,possibly due to such causes as frequently attacking of close-open cycles in small airway induced by such a respiratory status at a low lung capacity,and then,to induce inflammation and oxidative stress reaction in airway mucosa.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 肺功能 小气道 病理生理学机制 

分 类 号：R766[医药卫生—耳鼻咽喉科]