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目的:对高海拔地区阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者肺功能指标的变化分析,探讨低氧环境对OSAHS患者肺功能的影响及可能危险因素。方法:分别选择(海拔2 260m~3 700m)经多导睡眠图监测(PSG)确诊的OSAHS患者28例(OSAHS组)及36例体检健康者(对照组),分别行肺通气功能检测指标包括潮气量(VT)、每分通气量(MV)、最大肺活量(VC)、深吸气量(IC)、补呼气量(ERV)、用力肺活量(FVC)、1秒用力呼气容积(FEV1)、1秒率(FEV1/FVC)、最大分钟通气量(MVV)、用力呼气峰流量(PEF)和75%用力呼气容积流量(FEF75)、50%用力呼气容积流量(FEF50)、25%用力呼气容积流量(FEF25)测定及比较在高原环境下上述指标的变化,并监测两组动脉血氧饱和度(SaO_2)。结果:OSAHS组MV、MVV、FVC、VC、VT较对照组明显下降,差异有统计学意义(P<0.05),OSAHS组的FEV1、FEV1/FVC、FEF 25%~75%、ERV、PEF、SaO_2等指标明显低于对照组,差异有统计学意义(P<0.001)。OSAHS组肺功能受损主要表现为限制性通气功能受损,其次为小气道功能受损和阻塞性通气功能受损。结论:高海拔低氧环境下OSAHS对肺功能存在影响,夜间缺氧程度与肺功能损害程度有关,是OSAHS发生率增加的危险因素,为诠释低氧环境对OSAHS患者肺功能损伤的机理与发病规律提供理论与实验依据。
Objective: To analyze the changes of pulmonary function indexes in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) at high altitude and explore the influence of hypoxic environment on the lung function of OSAHS patients and the possible risk factors. Methods: Twenty-eight OSAHS patients (OSAHS group) and 36 healthy controls (PS group) diagnosed by polysomnography (PSG) were enrolled in this study. Lung ventilatory function test indexes VT, MV, VC, IC, ERV, FVC, FEV1 (FEV1) ), FEV 1 / FVC, MVV, PEF, FEF 75, FEF 50, 25% forced expiratory volume flow (FEF25) were measured and compared in the plateau environment changes in these indicators, and two groups of arterial oxygen saturation (SaO_2). Results: The MV, MVV, FVC, VC and VT in OSAHS group were significantly lower than those in control group (P <0.05). The FEV1, FEV1 / FVC, FEF 25% -75%, ERV, PEF, SaO_2 and other indicators were significantly lower than the control group, the difference was statistically significant (P <0.001). Pulmonary dysfunction in the OSAHS group was mainly manifested as impaired restrictive ventilatory function followed by impaired small airway function and obstructive ventilatory function. CONCLUSIONS: OSAHS at high altitude and hypoxia have an effect on pulmonary function. The degree of nocturnal hypoxia is related to the degree of pulmonary dysfunction. It is a risk factor for the increased incidence of OSAHS. To explain the mechanism and pathogenesis of pulmonary function impairment in patients with OSAHS under hypoxic environment Law provides theoretical and experimental basis.