阻塞性睡眠呼吸暂停低通气综合征患者的肺功能变化分析

doi:10.6040/j.issn.1673-3770.0.2022.043

摘要/Abstract

摘要： 目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者肺功能变化情况及其与肥胖的关系。方法回顾性收集烟台毓璜顶医院耳鼻咽喉头颈外科2015年1月-2021年6月的非OSAHS患者及OSAHS患者住院资料共169例,分析患者的肺功能指标及多导睡眠监测(PSG)结果,比较非OSAHS患者与OSAHS患者的肺功能指标,并将OSAHS患者的肺功能指标与PSG结果行相关性分析。结果 OSAHS患者的AHI与BMI呈正相关。最大肺活量(VCmax)、用力肺活量(FVCex)、潮气量(VT)、深吸气量(IC)、第1秒用力呼气量(FEV1)在重度组与非OSAHS组间存在差异。在OSAHS患者中AHI与VCmax、FVCex、PEF、FEV1、IC成负相关,BMI与VCmax、IC、FVCex成负相关。结论 OSAHS患者存在肺功能损害,且在重度患者中更加明显,肥胖可能是导致OSAHS患者肺功能损害的因素之一。

关键词: 阻塞性睡眠呼吸暂停低通气综合征, 肺功能, 肥胖, 通气功能障碍, 多导睡眠监测

Abstract: Objective To investigate the relationship between pulmonary function and obesity in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods A total of 169 cases of patients with and without OSAHS who were hospitalized in the Department of Otolaryngology & Head and Neck Surgery, Yuhuangding Hospital, Yantai from January 2015 to June 2021 were retrospectively analyzed. Analysis of pulmonary function and polysomnography(PSG)monitoring results and comparison of pulmonary function indicators of the non-OSAHS group and OSAHS group were conducted. The correlation between the pulmonary function indices and PSG results of patients with OSAHS was also identified. Results Apnea-hypopnea index(AHI)and body mass index(BMI)were positively correlated. Maximum vital capacity(Vcmax), forced vital capacity(FVCex), tidal volume(VT), inspiratory capacity(IC), and forced expiratory volume in one second(FEV1)were different between the severe and control groups. AHI was negatively correlated with VCmax, FVCex, PEF, FEV1, and IC. BMI was negatively correlated with VCmax, IC, and FVCex. Conclusion Patients with OSAHS had pulmonary function impairment, which was more apparent in severe patients. Obesity may be a factor leading to pulmonary function impairment in patients with OSAHS.

Key words: Obstructive sleep apnea-hypopnea syndrome, Pulmonary function, Obesity, Ventilatory dysfunction, Polysomnography

中图分类号:

R766.7

李卓君,宋西成,陈秀梅. 阻塞性睡眠呼吸暂停低通气综合征患者的肺功能变化分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 45-50.

LI Zhuojun, SONG Xicheng, CHEN Xiumei. Analysis of pulmonary function changes in patients with obstructive sleep apnea hypopnea syndrome[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 45-50.

参考文献

[1] Semelka M, Wilson J, Floyd R. Diagnosis and treatment of obstructive sleep apnea in adults[J]. Am Fam Physician, 2016, 94(5): 355-360.
[2] Brock JM, Billeter A, Müller-Stich BP, et al. Obesity and the lung: what we know today[J]. Respiration, 2020, 99(10): 856-866. doi:10.1159/000509735
[3] Wimms A, Woehrle H, Ketheeswaran S, et al. Obstructive sleep apnea in women: specific issues and interventions[J]. Biomed Res Int, 2016: 1764837. doi:10.1155/2016/1764837
[4] 唐志君, 韦宗辉, 吴勇德, 等. 重度阻塞性睡眠呼吸暂停低通气综合征患者的肺功能分析[J]. 上海交通大学学报(医学版), 2016, 36(12): 1817-1819. doi:10.3969/j.issn.1674-8115.2016.12.028 TANG Zhijun, WEI Zonghui, WU Yongde, et al. Analysis of pulmonary function in patients with severe obstructive sleep apnea-hypopnea syndrome[J]. Journal of Shanghai Jiao Tong University(Medical Science), 2016, 36(12): 1817-1819. doi:10.3969/j.issn.1674-8115.2016.12.028
[5] Elwali A, Moussavi Z. Obstructive sleep apnea screening and airway structure characterization during wakefulness using tracheal breathing sounds[J]. Ann Biomed Eng, 2017, 45(3): 839-850. doi:10.1007/s10439-016-1720-5
[6] 王扬, 朱鲁平, 陈仁杰. 阻塞性睡眠呼吸暂停低通气综合征与肥胖相关的研究进展[J]. 中国中西医结合耳鼻咽喉科杂志, 2019, 27(2): 156-160. doi:10.16542/j.cnki.issn.1007-4856.2019.02.027 WANG Yang, ZHU Luping, CHEN Renjie. Research progress on the correlation between obesity and obstructive sleep apnea hypopnea syndrome[J]. Chinese Journal of Otorhinolaryngology in Integrative Medicine, 2019, 27(2): 156-160. doi:10.16542/j.cnki.issn.1007-4856.2019.02.027
[7] 杨荣刚, 叶京英, 张玉焕, 等. 肺容量与阻塞性睡眠呼吸暂停低通气综合征关系的研究[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(4): 295-299. doi:10.3760/cma.j.issn.1673-0860.2013.04.007 YANG Ronggang, YE Jingying, ZHANG Yuhuan, et al. Correlation between lung volume and the severity of obstructive sleep apnea hypopnea syndrome in obese patients[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2013, 48(4): 295-299. doi:10.3760/cma.j.issn.1673-0860.2013.04.007
[8] 刘小行, 朱述阳. 不同严重程度的阻塞性睡眠呼吸暂停低通气综合征患者的肺功能分析[J]. 临床肺科杂志, 2020, 25(4): 510-514. doi:10.3969/j.issn.1009-6663.2020.04.006 LIU Xiaoxing, ZHU Shuyang. Analysis of pulmonary function in patients with different severity of obstructive sleep apnea hypopnea syndrome[J]. Journal of Clinical Pulmonary Medicine, 2020, 25(4): 510-514. doi:10.3969/j.issn.1009-6663.2020.04.006
[9] Mortimore IL, Marshall I, Wraith PK, et al. Neck and total body fat deposition in nonobese and obese patients with sleep apnea compared with that in control subjects[J]. Am J Respir Crit Care Med, 1998, 157(1): 280-283. doi:10.1164/ajrccm.157.1.9703018
[10] Zhang J, Zhao J, Chen M, et al. Airway resistance and allergic sensitization in children with obstructive sleep apnea hypopnea syndrome[J]. Pediatr Pulmonol, 2016, 51(4): 426-430. doi:10.1002/ppul.23264
[11] 姜珊, 王彦, 张静, 等. OSAHS合并肥胖低通气综合征患者的临床特征分析[J]. 天津医科大学学报, 2021, 27(1): 17-21. JIANG Shan, WANG Yan, ZHANG Jing, et al. Study on the clinical characteristics of obstructive sleep apnea-hypopnea syndrome combined with obesity hypopnea syndrome[J]. Journal of Tianjin Medical University, 2021, 27(1): 17-21.
[12] 蔡泽川, 李涛平, 陆晓霞, 等. 阻塞性睡眠呼吸暂停低通气综合征的呼吸阻力变化的意义[J]. 南方医科大学学报, 2018, 38(6): 765-768. doi:10.3969/j.issn.1673-4254.2018.06.20 CAI Zechuan, LI Taoping, LU Xiaoxia, et al. Alterations of respiratory resistance in patients with obstructive sleep apnea hypopnea syndrome[J]. Journal of Southern Medical University, 2018, 38(6): 765-768. doi:10.3969/j.issn.1673-4254.2018.06.20. doi:10.3969/j.issn.1673-4254.2018.06.20
[13] Bonsignore MR, Saaresranta T, Riha RL. Sex differences in obstructive sleep apnoea[J]. Eur Respir Rev, 2019, 28(154): 190030. doi:10.1183/16000617.0030-2019
[14] Younes M. Pathogenesis of obstructive sleep apnea[J]. Clin Chest Med, 2019, 40(2): 317-330. doi:10.1016/j.ccm.2019.02.008
[15] Shimura R, Tatsumi K, Nakamura A, et al. Fat accumulation, leptin, and hypercapnia in obstructive sleep apnea-hypopnea syndrome[J]. Chest, 2005, 127(2): 543-549. doi:10.1378/chest.127.2.543
[16] Pillar G, Shehadeh N. Abdominal fat and sleep apnea: the chicken or the egg? [J]. Diabetes Care, 2008, 31, 2(7): 303-309. doi:10.2337/dc08-s272
[17] Rouatbi S, Ghannouchi I, Kammoun R, et al. The ventilatory and diffusion dysfunctions in obese patients with and without obstructive sleep apnea-hypopnea syndrome[J]. J Obes, 2020: 8075482. doi:10.1155/2020/8075482
[18] Tagaito Y, Isono S, Remmers JE, et al. Lung volume and collapsibility of the passive pharynx in patients with sleep-disordered breathing[J]. J Appl Physiol(1985), 2007, 103(4): 1379-1385. doi:10.1152/japplphysiol.00026.2007
[19] 关乐静, 张亚梅. 阻塞性睡眠呼吸暂停低通气综合征对儿童肺功能的影响[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 75-80. doi: 10.6040/j.issn.1673-3770.0.2015.511 GUAN Lejing, ZHANG Yamei. The effect of obstructive sleep apnea-hypopnea syndrome on pulmonary function of child:a literature review.[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(5): 75-80. doi: 10.6040/j.issn.1673-3770.0.2015.511
[20] 袁晨阳, 刘燕, 房振胜. 儿童阻塞性睡眠呼吸暂停低通气综合征对肺功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 143-148. doi: 10.6040/j.issn.1673-3770.0.2020.386 YUAN Chenyang, LIU Yan, FANG Zhensheng. Advances on the effect of OSAHS on pulmonary function in children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 143-148. doi: 10.6040/j.issn.1673-3770.0.2020.386

相关文章 15

[1]	张晓雪,王伟,刘杰,许贞菊,钱永恒,韩敏. 儿童与成人OSAHS患者的口咽部菌群特征及药敏学分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 35-40.
[2]	李超友,王安洋，薛刚. 中心型肥胖与头颈癌的关系[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 120-125.
[3]	韩莹莹，李延忠. 阻塞性睡眠呼吸暂停低通气综合征与亚临床动脉粥样硬化[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 126-132.
[4]	郑莉,许志飞. 睡眠呼吸障碍为首发表现的Chiari畸形幼儿1例报道并文献复习[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 111-115.
[5]	袁晨阳, 刘燕, 房振胜. 儿童阻塞性睡眠呼吸暂停低通气综合征对肺功能的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(1): 143-148.
[6]	季迪,邓安春. 外科干预对阻塞性睡眠呼吸暂停低通气综合征患者血压影响的系统评价[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 92-98.
[7]	田秋实,胡文婷,逄明杰. 变应性鼻炎鼻分泌物嗜酸性粒细胞与肺功能相关性研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 52-55.
[8]	李晓, 袁英, 李延忠, 王岩, 杨珂, 孙永强, 于学民, 王宁, 王磊. 焦虑抑郁对阻塞性睡眠呼吸暂停低通气综合征患者夜间血压波动的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(6): 68-71.
[9]	王亚坤,张宇,宋西成. 不伴有下气道疾病的慢性鼻-鼻窦炎患者肺功能及相关因素分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 99-102.
[10]	王建伟,张宇,宋西成. 慢性鼻-鼻窦炎伴鼻息肉合并哮喘患者肺功能分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 103-108.
[11]	杜经纬,冯俊,马鹏,李志勇,李红光. 鼻腔冲洗联合鼻用糖皮质激素对AR患者FeNO、肺功能及生活质量的影响[J]. 山东大学耳鼻喉眼学报, 2019, 33(1): 124-127.
[12]	刘文君,于雪莹,吕丹,陈正岗,张艳青,梅栩彬,杨珂. 不同性别阻塞性睡眠呼吸暂停低通气综合征患者与上气道影像学相关性的研究[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 54-59.
[13]	葛晓辉,王宁宇,占小俊,王春燕,王建亭,王辉,郝荣颖,马坤,刘萍,李丽. 手术对阻塞性睡眠呼吸暂停低通气综合征患者血脂代谢变化的临床观察[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 27-30.
[14]	李延忠. 肥胖与阻塞性睡眠呼吸暂停[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 1-4.
[15]	高天喜,夏翠,闫静,侯瑾,康全清,王正辉,任晓勇. 间歇低氧模型大鼠肝脏组织中IGF-1、IGFBP-3的表达及分析[J]. 山东大学耳鼻喉眼学报, 2016, 30(5): 38-41.

多维度评价

Viewed

Full text

Abstract

Cited

Shared

Discussed