Whyte K F, Douglas N J
Department of Respiratory Medicine, University of Edinburgh, Scotland.
Sleep. 1991 Aug;14(4):354-6.
To clarify the roles of lung function, nocturnal hypoxemia and obesity in the development of peripheral edema in patients with the sleep apnea/hypopnea syndrome (SAHS), 65 consecutive SAHS patients had diagnostic sleep studies and respiratory function testing. Eighteen patients (27%) had peripheral edema without other explanation. Their sleep apnea/hypopnea index was similar to those without edema, but they were more obese (p less than 0.01) and had worse lung function (p less than 0.01) and lower oxygen saturation (SaO2) awake (p less than 0.01). These 18 became more hypoxemic during sleep than predicted from their awake SaO2 (p less than 0.005). Eleven patients with edema had evidence of pulmonary hypertension on cardiac catheterization, chest radiograph, or electrocardiograph and could be weight matched to 11 SAHS patients without edema. Those with right heart failure were more hypoxic (p less than 0.01) when awake, desaturated more frequently during sleep (p less than 0.01), and had lower FEV1% predicted (p less than 0.01). Thus, extent of both daytime and nighttime hypoxemia are important in the development of right heart failure in patients with SAHS.
为阐明肺功能、夜间低氧血症及肥胖在睡眠呼吸暂停/低通气综合征（SAHS）患者外周性水肿发生中的作用，对65例连续性SAHS患者进行了诊断性睡眠研究及呼吸功能检测。18例患者（27%）出现外周性水肿且无其他原因可解释。他们的睡眠呼吸暂停/低通气指数与无水肿患者相似，但他们更肥胖（p<0.01），肺功能更差（p<0.01），清醒时氧饱和度（SaO2）更低（p<0.01）。这18例患者睡眠期间的低氧血症比根据其清醒时SaO2所预测的更严重（p<0.005）。11例有水肿的患者在心脏导管检查、胸部X线片或心电图上有肺动脉高压的证据，可与11例无水肿的SAHS患者进行体重匹配。那些有右心衰竭的患者清醒时缺氧更严重（p<0.01），睡眠期间更频繁地出现氧饱和度下降（p<0.01），且预测的第1秒用力呼气容积百分比（FEV1%）更低（p<0.01）。因此，日间和夜间低氧血症的程度在SAHS患者右心衰竭的发生中均很重要。
