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通过脉冲振荡法研究姿势对阻塞性睡眠呼吸暂停低通气综合征气道阻力的影响。

Effect of posture on airway resistance in obstructive sleep apnea-hypopnea syndrome by means of impulse oscillation.

作者信息

Cao Ju, Que Chengli, Wang Guangfa, He Bing

机构信息

Respiratory Department of Internal Medicine, First Hospital of Peking University, Beijing, China.

出版信息

Respiration. 2009;77(1):38-43. doi: 10.1159/000114146. Epub 2008 Jan 24.

DOI:10.1159/000114146
PMID:18216458
Abstract

BACKGROUND

There is more than one mechanism which contributes to the increases in upper airway resistance in obstructive sleep apnea and hypopnea syndrome. Impulse oscillation provides a convenient way of noninvasive monitoring and differentiating the contributions of airway resistance.

OBJECTIVE

To evaluate the effect of posture on airway resistance in obstructive sleep apnea-hypopnea syndrome (OSAHS) by means of impulse oscillation.

METHODS

Ten subjects without OSAHS proved by polysomnography served as controls, 14 patients with mild or moderate OSAHS and another 20 severe OSAHS patients were studied. All subjects underwent an overnight sleep study. Airway resistance was measured by impulse oscillometry, and spirometry was performed in the seated position and then in the supine position while awake.

RESULTS

Compared with controls, the severe and the mild-moderate OSAHS groups had significantly bigger changes in Zrs, Rrs5, R20 and R35 due to posture. There were also significant differences in R10, R15 and R25 between the severe OSAHS and the control groups. Besides, the group differences between the severe and the mild-moderate groups regarding the magnitude of this change were not significant. The correlation coefficients between apnea/hypopnea index and Zrs, R5 and R20 in supine position were 0.487, 0.486 and 0.485, respectively.

CONCLUSION

The magnitude of change in airway resistance due to posture is bigger in OSAHS than in non-OSAHS. Zrs, R5 and R20 in supine position were associated moderately with apnea/hypopnea index.

摘要

背景

阻塞性睡眠呼吸暂停低通气综合征中,有多种机制导致上气道阻力增加。脉冲振荡提供了一种方便的无创监测和区分气道阻力贡献的方法。

目的

通过脉冲振荡评估姿势对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)气道阻力的影响。

方法

经多导睡眠图证实无OSAHS的10名受试者作为对照,研究14例轻度或中度OSAHS患者和另外20例重度OSAHS患者。所有受试者均进行了整夜睡眠研究。通过脉冲振荡法测量气道阻力,并在清醒时先坐位后仰卧位进行肺量计检查。

结果

与对照组相比,重度和轻度 - 中度OSAHS组由于姿势导致的气道阻力频率依赖黏性阻力(Zrs)、5Hz时的共振频率下黏性阻力(Rrs5)、20Hz时的黏性阻力(R20)和35Hz时的黏性阻力(R35)变化显著更大。重度OSAHS组与对照组之间在10Hz时的黏性阻力(R10)、15Hz时的黏性阻力(R15)和25Hz时的黏性阻力(R25)也存在显著差异。此外,重度组与轻度 - 中度组之间在这种变化幅度上的组间差异不显著。仰卧位时呼吸暂停/低通气指数与Zrs、R5和R20的相关系数分别为0.487、0.486和0.485。

结论

OSAHS患者因姿势导致的气道阻力变化幅度大于非OSAHS患者。仰卧位时的Zrs、R5和R20与呼吸暂停/低通气指数中度相关。

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