Blankfield Robert P, Ahmed Mansoor, Zyzanski Stephen J
Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Sleep Med. 2004 Nov;5(6):583-7. doi: 10.1016/j.sleep.2004.06.009.
This study was undertaken to clarify whether idiopathic edema is a marker for obstructive sleep apnea (OSA), independent of level of obesity, in patients with normal left ventricular function.
Seventy-eight ambulatory, obese, adults, 44 with bilateral, pitting pre-tibial edema, and 34 without edema, from an inner city family practice and a suburban family practice enrolled from July 1995 until March 2003. Edematous subjects, but not non-edematous subjects, underwent echocardiography, urinalysis, and blood test evaluations to ensure that cardiac, renal, hepatic, and thyroid functions were normal. All subjects underwent spirometry, pulse oximetry on room air, and polysomnography evaluations.
Compared to the non-edematous subjects, the edematous subjects were more obese (body mass index=47.0+/-9.3 versus 36.5+/-4.6 kg/m2, P=0.002), had more severe OSA (apnea-hypopnea index (AHI)=34.1+/-27.7 versus 17.0+/-19.4, P=0.002), and had lower oxygen saturations (96.2+/-2.0 versus 97.1+/-1.5%, P=0.05). Using an AHI > or = 15 as the criteria for diagnosing OSA, there was an association between edema and OSA in women (P=0.02) but not men.
In subjects with normal left ventricular function, idiopathic edema is associated with OSA in women.
本研究旨在明确在左心室功能正常的患者中，特发性水肿是否为阻塞性睡眠呼吸暂停（OSA）的一个标志物，且独立于肥胖程度。
从1995年7月至2003年3月，选取了78名非卧床、肥胖的成年人，其中44名患有双侧胫前凹陷性水肿，34名无水肿，分别来自市内一家家庭诊所和一家郊区家庭诊所。对有水肿的受试者（而非无水肿的受试者）进行了超声心动图、尿液分析和血液检测评估，以确保心脏、肾脏、肝脏和甲状腺功能正常。所有受试者均接受了肺活量测定、室内空气中的脉搏血氧饱和度测定以及多导睡眠图评估。
与无水肿的受试者相比，有水肿的受试者更肥胖（体重指数=47.0±9.3对36.5±4.6kg/m²，P=0.002），OSA更严重（呼吸暂停低通气指数（AHI）=34.1±27.7对17.0±19.4，P=0.002），且氧饱和度更低（96.2±2.0对97.1±1.5%，P=0.05）。以AHI≥15作为诊断OSA的标准，女性中水肿与OSA之间存在关联（P=0.02），而男性中则无。
在左心室功能正常的受试者中，特发性水肿在女性中与OSA相关。
