Amado V M, Costa A C, Guiot M, Viegas C A, Tavares P
Departamento de Clínica Médica, Faculdade de Ciências da Saúde, Universidade de Brasília, DF, Brasil.
Braz J Med Biol Res. 1999 Apr;32(4):407-11. doi: 10.1590/s0100-879x1999000400005.
We analyzed the flow-volume curves of 50 patients with complaints of snoring and daytime sleepiness in treatment at the Pneumology Unit of the University Hospital of Brasília. The total group was divided into snorers without obstructive sleep apnea (OSA) (N = 19) and snorers with OSA (N = 31); the patients with OSA were subdivided into two groups according to the apnea/hypopnea index (AHI): AHI < 20/h (N = 14) and AHI > 20/h (N = 17). The control group (N = 10) consisted of nonsmoking subjects without complaints of snoring, daytime sleepiness or pulmonary diseases. The population studied (control and patients) consisted of males of similar age, height and body mass index (BMI); spirometric data were also similar in the four groups. There was no significative difference in the ratio of forced expiratory and inspiratory flows (FEF50%/FIF50%) in any group: control. 0.89; snorers, 1.11; snorers with OSA (AHI < 20/h), 1.42, and snorers with OSA (AHI > 20/h), 1.64. The FIF at 50% of vital capacity (FIF50%) of snoring patients with or without OSA was lower than the FIF50% of the control group (P < 0.05): snorers 4.30 l/s; snorers with OSA (AHI < 20/h) 3.69 l/s; snorers with OSA (AHI > 20/h) 3.17 l/s and control group 5.48 l/s. The FIF50% of patients with severe OSA (AHI > 20/h) was lower than the FIF50% of snorers without OSA (P < 0.05): 3.17 l/s and 4.30 l/s, respectively. We conclude that 1) the FEF50%/FIF50% ratio is not useful for predicting OSA, and 2) FIF50% is decreased in snoring patients with and without OSA, suggesting that these patients have increased upper airway resistance (UAR).
我们分析了巴西利亚大学医院肺病科正在接受治疗的50例主诉打鼾和日间嗜睡患者的流量-容积曲线。整个组被分为无阻塞性睡眠呼吸暂停(OSA)的打鼾者(N = 19)和有OSA的打鼾者(N = 31);有OSA的患者根据呼吸暂停/低通气指数(AHI)被细分为两组:AHI < 20/小时(N = 14)和AHI > 20/小时(N = 17)。对照组(N = 10)由无打鼾、日间嗜睡或肺部疾病主诉的非吸烟受试者组成。所研究的人群(对照组和患者)由年龄、身高和体重指数(BMI)相似的男性组成;四组的肺量计数据也相似。任何组(对照组、打鼾者、AHI < 20/小时的有OSA的打鼾者、AHI > 20/小时的有OSA的打鼾者)的用力呼气与吸气流量比(FEF50%/FIF50%)均无显著差异:对照组为0.89;打鼾者为1.11;AHI < 20/小时的有OSA的打鼾者为1.42,AHI > 20/小时的有OSA的打鼾者为1.64。有或无OSA的打鼾患者在肺活量的50%时的吸气流量(FIF50%)低于对照组的FIF50%(P < 0.05):打鼾者为4.30升/秒;AHI < 20/小时的有OSA的打鼾者为3.69升/秒;AHI > 20/小时的有OSA的打鼾者为3.17升/秒,对照组为5.48升/秒。重度OSA(AHI > 20/小时)患者的FIF50%低于无OSA的打鼾者的FIF50%(P < 0.05):分别为3.17升/秒和4.30升/秒。我们得出结论:1)FEF50%/FIF50%比值对预测OSA无用;2)有或无OSA的打鼾患者的FIF50%均降低,提示这些患者的上气道阻力(UAR)增加。