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[肢端肥大症与睡眠呼吸暂停综合征——病例报告]

[Acromegaly and sleep apnoea syndrome--case report].

作者信息

Pływaczewski R, Bednarek M, Jonczak L, Zieliński J

机构信息

Kliniki Chorób Płuc Instytutu Gruźlicy i Chorób Płuc w Warszawie.

出版信息

Pneumonol Alergol Pol. 2001;69(9-10):568-73.

Abstract

We studied 65-year old, obese man suspected of obstructive sleep apnoea. He gave a history of loud snoring and excessive daytime sleepiness. We confirmed sleep apnoea syndrome during limited polysomnography with Polymesam (RDI--45/h, ODI--47/h). Patient had mainly obstructive episodes, however central and mixed apnoeas constituted about 1/3 of all episodes. During hospitalization we observed exacerbation of coronary artery disease and diagnosed diabetes. Patient's coarsened facial features, macroglossia and large hands led us to suspect acromegaly. Brain MR study revealed small pituitary adenoma. Plasma GH and IGF-1 concentrations were increased. Active acromegaly was diagnosed and was proposed a surgical treatment but he refused. Symptoms of sleep apnoea relieved after CPAP treatment. After one year patient's condition remained stable.

摘要

我们研究了一名65岁、疑似阻塞性睡眠呼吸暂停的肥胖男性。他有大声打鼾和白天过度嗜睡的病史。我们通过使用Polymesam进行有限的多导睡眠图检查确诊了睡眠呼吸暂停综合征(呼吸紊乱指数——每小时45次,氧减指数——每小时47次)。患者主要是阻塞性发作,然而中枢性和混合性呼吸暂停约占所有发作的三分之一。住院期间,我们观察到冠状动脉疾病加重并诊断出糖尿病。患者面部特征粗糙、巨舌和大手使我们怀疑患有肢端肥大症。脑部磁共振成像研究显示有小的垂体腺瘤。血浆生长激素和胰岛素样生长因子-1浓度升高。确诊为活动性肢端肥大症,并建议进行手术治疗,但他拒绝了。持续气道正压通气治疗后睡眠呼吸暂停症状缓解。一年后患者病情保持稳定。

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