| 李文丽,陈碧,季磊,等.阻塞性睡眠呼吸暂停综合征对肥胖病人肺功能的影响分析[J].安徽医药,2024,28(1):67-74. |
| 阻塞性睡眠呼吸暂停综合征对肥胖病人肺功能的影响分析 |
| Effect of obstructive sleep apnea syndrome on pulmonary function in obese patients |
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| DOI：10.3969/j.issn.1009-6469.2024.01.015 |
| 中文关键词: 睡眠呼吸暂停，阻塞性 肥胖 血气分析 肺功能 呼吸紊乱指数 .、BMI对Kco具有显著影，，， |
| 英文关键词: Sleep apnea,obstructive Obesity Blood gas analysis Pulmonary function Disordered breathing index |
| 基金项目:江苏省“六大人才高峰”高层次人才项目( WSN-081)；徐州市科技项目( KC20072) |
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| 中文摘要: |
| 目的探讨阻塞性睡眠呼吸暂停综合征( obtructive sleep apnea，OSAHS)对肥胖病人肺功能的影响。方法选取 2018年 9月至 2022年 4月徐州医科大学附属医院睡眠中心就诊的 160例肥胖病人，行多导睡眠监测( polysomnography，PSG)、肺功能检查及血液相关化验，依据呼吸暂停低通气指数( apnea hypopnea index，AHI)分为四组:单纯肥胖组( 33例)、肥胖合并轻度 OSAHS组( 31例)、肥胖合并中度 OSAHS组( 32例)、肥胖合并重度 OSAHS组( 64例)分析年龄、身体质量指数( BMI)、 Epworth嗜睡量表( epworthsleepiness scale，ESS)、 AHI、平均血氧饱和度( MSaO2)、最低血氧饱和，度( LSaO2)、最长呼吸暂停时间( LAT)、各项肺功能指标。结果与单纯肥胖组相比，肥胖合并重度 OSAHS组肺总量( TLC)［(82.27±13.89)L比( 91.30±8.94)L］、重度组肺活量、用力肺活量(FVC)、补呼气容积( ERV)显著减低(P<0.05)。校正 BMI、年龄后， AHI与肺活量、 FVC、TLC、功能残气量(FRC)呈负相关(P<0.05)AHI与一秒率(FEV1/FVC)、每升肺泡容积的一氧化碳弥散量(Kco)呈正相关( P<0.05)； MSaO2与肺活量、 FVC、TLC及第 1秒用力，呼气容积( FEV1)呈正相关( P<0.05)； LSaO2与肺活量、 FVC、ERV、FEV1TLC、FRC呈正相关( P<0.05)，LSaO2与 Kco呈负相关( P<0.05)。多因素逐步回归分析结果显示 AHI对 FVC具有显著影响( P<005)LSaO2、MSaO2对肺活量、 TLC具有显著影响( P<0.05)LSaO2、BMI对 FEV1具有显著影响( P<0.05)，AHI、 响( P<0.05)。结论对于患有 OSAHS的肥胖病人尤其是严重 OSAHS病人，其多项肺功能指标明显下降； AHI是肥胖病人肺功能指标 FVC的独立危险因子， LSaO2是肥胖病人肺活量、 TLC、FEV1损害的独立危险因子。 AHI和 LSaO2可能成为肥胖合并 OSAHS病人肺功能损害的预测因子，肺功能检查可以作为肥胖病人 OSAHS严重程度的辅助评估手段。 |
| 英文摘要: |
| Objective To study the effects of obstructive sleep apnea (OSAHS) on lung function in obese patients.Methods One hundred and sixty obese patients who underwent polysomnography (PSG), pulmonary function examination and blood related tests whoadmitted to the Sleep Center of Affiliated Hospital of Xuzhou Medical University from September 2018 to April 2022 were selected.They were assigned into four groups according to apnea hypopnea index (AHI): simple obesity group (33 cases), obese patients withmild OSAHS (31 cases), obese patients with moderate OSAHS (32 cases) and obese patients with severe OSAHS (64 cases). EpworthSleepiness Scale (ESS), AHI, mean saturation oxygen (MSaO2), lowest arterial saturation oxygen (LSaO2) longest apnea time (LAT), and various pulmonary function indicators were analyzed.Results Compared with the simple obesity group, the total lung volume (TLC) [ratio of (82.27±13.89) vs. (91.30±8.94) L], vital capacity (VC), forced vital capacity (FVC) and expiratory volume (ERV) in the obesitycombined with severe OSAHS group were significantly decreased (P<0.05). After adjusting for BMI and age, AHI was negatively corre- lated with VC, FVC, TLC and FRC (P<0.05), and significantly positively correlated with FEV1/FVC and Kco (P<0.05); MSaO2 was posi- tively correlated with VC, FVC, TLC and FEV1 (P<0.05); LSaO2 was positively correlated with ERV, VC, FVC, FEV1, TLC, FRC (P< 0.05) and LSaO2 was negatively correlated with Kco (P<0.05). Multivariate stepwise regression analysis showed that AHI had signifi- cant effects on FVC (P<0.05), LSaO2 and MSaO2 had significant effects on VC and TLC (P<0.05), LSaO2 and BMI had significant ef- fects on FEV1 (P<0.05), and AHI and BMI had significant effects on Kco (P<0.05).Conclusions The severity of OSAHS in obese pa-tients is closely associated with various respiratory dysfunctions, and AHI is an independent risk factor for FVC of lung function in obese patients. LSaO2 is an independent risk factor for VC, TLC and FEV1 of lung function in obese patients. AHI and LSaO2 may be-come predictors of pulmonary function damage in obese patients with OSAHS, and pulmonary function tests can be an adjunct to assess-ing the severity of OSAHS in obese patients. |
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