脉冲振荡肺功能在阻塞性睡眠呼吸暂停低通气综合征中的应用

摘要

目的:观察脉冲振荡(IOS)呼吸阻抗值在阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者中的变化,并探讨其在OSAHS诊断中的应用价值.方法:对38例OSAHS患者(OSAHS组)、22倒单纯打鼾而无睡眠呼吸暂停患者(单纯鼾症组)和20名健康人(对照组)进行IOS肺功能检测,比较3组的呼吸阻抗指标,并将OSAHS患者睡眠监测有关指标与呼吸阻抗指标进行相关性分析.结果:OSAHS患者上气道阻力(R35)、中心气道阻力(R20)、呼吸总阻抗(Zrs)、总气道阻力(R5)明显高于单纯鼾症组和对照组,差异有非常显著性(P＜0.01),单纯鼾症组又高于对照组,差异亦有显著性(P＜0.05).OSAHS组呼吸暂停低通气指数(AHI)与R35和R20呈正相关.相关系数(r)分别为0.623和0.617(P＜0.01);最低SO2与R35、R20、Zrs 呈负相关,r分别为-0.607、-0.591和-0.462(P＜0.01).结论:IOS肺功能可作为检测OSAHS患者上气道阻力的一种方法,为非睡眠状态下OSAHS诊断及病情程度判断提供帮助.%Objective To observe the variation of impulse oscillometry respiratiry impedance in patients with obstructive sleep apnea-hyponpnea (OSAHS) and to explore its application value in the diagnosis of OSAHS. Methods pulmonary function in 38 patients with OSAHS (OSAHS group), 22 patients with simple snoring without sleep apnea (simple snoring group), and 20 healthy people (control group) were measured by impulse oscillometry. Respiratiry impedance indicators of the 3 groups were compared. The correlations of sleep monitoringrnindex and respiratiry impedance indicator were analyzed. Results Upper airway resistance (R35), central airway resistance (R20), respiratiry impedance (Zrs), and total airway resistance (R5) in OSAHS group were significantly higher than those in simple snoring group and control group (P ＜ 0.01), and simple snoring group were higher than control group (P ＜ 0.05). In OSAHS group, apnea-hypopnea index (AHI) was positively correlated with R35 and R20 (r = 0.623 and 0.617) (P ＜ 0.01) ; the lowest S02 was negatively correlated with R35, R20, and Zrs (r = -0.607, -0.591, and -0.462) (P ＜ 0.01). Conclusion Impulse oscillometry pulmonary function could be used as a method to detect upper airway resistance of OSAHS patients, and could be used to help to diagnose and evaluate severity of OSAHS during non-sleeping.