Khan J H, Bazarbashi M, Stigsby B, Al-Ohaly Y
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Ann Saudi Med. 1995 Sep;15(5):443-6. doi: 10.5144/0256-4947.1995.443.
Patients with sleep apnea syndrome (SAS) suffer considerable morbidity and increased mortality. The most common symptoms of SAS include excessive daytime sleepiness, nocturnal breath cessation, snoring and gasping sounds. We reviewed the characteristics of 20 Saudi patients with sleep apnea (15 males, five females) who were studied at our tertiary care center in 1992 and 1993. The ages ranged from 15 to 61 years. All were obese. Two each were acromegalic and hypothyroid. Hypertension was noted in seven (35%) patients and one had symptomatic bradycardia. Two (10%) patients presented with recurrent pulmonary emboli and two were involved in multiple road traffic accidents as a result of falling asleep while driving. One male student had poor performance at school. Three patients were known to have chronic obstructive airway disease. Six males and one female were hypercapnic (PCO2; > 6.1 kPa) while 10 patients had hypoxemia (paO2; < 8.0 kPa). Four patients were polycythemic. Pulmonary function tests showed that 15 (75%) had restrictive patterns, three (15%) had obstructive patterns and two (10%) had mixed patterns. A "saw-tooth" pattern was seen in the inspiratory limb of a flow-volume curve in four patients. Daytime polysomnography showed that eight had obstructive sleep apnea, four had central sleep apnea and six had mixed type sleep apnea. Both hypothyroid patients improved with replacement therapy; one acromegalic patient and one patient with tracheal stenosis responded to specific treatment. Nasal positive airway pressure machine (BIPAPtrade mark Resperonics Inc) was effective in relieving apnea and reducing symptoms in five patients. None of the patients were able to lose a substantial amount of weight. All these patients were investigated extensively at different places prior to establishing the diagnosis.
睡眠呼吸暂停综合征（SAS）患者存在相当高的发病率和死亡率上升情况。SAS最常见的症状包括白天过度嗜睡、夜间呼吸暂停、打鼾和喘息声。我们回顾了1992年和1993年在我们三级医疗中心研究的20例沙特睡眠呼吸暂停患者的特征（15名男性，5名女性）。年龄范围为15至61岁。所有人均肥胖。各有2例患肢端肥大症和甲状腺功能减退症。7例（35%）患者有高血压，1例有症状性心动过缓。2例（10%）患者出现复发性肺栓塞，2例因驾车时睡着而发生多起道路交通事故。一名男学生在学校成绩不佳。3例患者已知患有慢性阻塞性气道疾病。6名男性和1名女性存在高碳酸血症（PCO2；>6.1 kPa），而10例患者有低氧血症（paO2；<8.0 kPa）。4例患者红细胞增多。肺功能测试显示，15例（75%）有限制性模式，3例（15%）有阻塞性模式，2例（10%）有混合性模式。4例患者的流量 - 容积曲线吸气支出现“锯齿”样模式。白天多导睡眠图显示，8例有阻塞性睡眠呼吸暂停，4例有中枢性睡眠呼吸暂停，6例有混合型睡眠呼吸暂停。两名甲状腺功能减退患者经替代治疗后病情改善；1例肢端肥大症患者和1例气管狭窄患者对特定治疗有反应。鼻持续气道正压通气机（BIPAP商标，瑞思迈公司）对5例患者缓解呼吸暂停和减轻症状有效。所有患者均未能大幅减重。所有这些患者在确诊前都在不同地方进行了广泛检查。
