Yoshizawa H, Nagao M, Nakano M, Satoh M, Nagai A, Kioi S, Arakawa M
Department of Medicine (II), Niigata University, School of Medicine.
Ryumachi. 1991 Jun;31(3):290-4; discussion 294-7.
A 55 year old man with malignant rheumatoid arthritis (MRA) was admitted because of severe snoring during sleep and hypersomnolence in the day time. The patient developed an episode of respiratory distress and cardiac arrest, which responded rapidly to tracheal intubation and mechanical ventilation. He could be easily weaned from ventilator after 3 days. Polysomnography showed that the patient had an obstructive sleep apnea syndrome. Lateral view of cranial radiography revealed acquired micrognathia and destruction of the temporomandibular joints caused by RA, which induced obstructive sleep apnea. It is important to consider that obstructive sleep apnea can occur in RA patients showing snoring, hypersomnolence and disordered sleep behavior.
一名55岁的男性患有恶性类风湿性关节炎（MRA），因睡眠时严重打鼾和白天嗜睡入院。患者出现了一次呼吸窘迫和心脏骤停，经气管插管和机械通气后迅速得到缓解。3天后他可以很容易地从呼吸机上撤机。多导睡眠图显示该患者患有阻塞性睡眠呼吸暂停综合征。头颅X线侧位片显示类风湿性关节炎导致获得性小颌畸形和颞下颌关节破坏，从而引发阻塞性睡眠呼吸暂停。对于出现打鼾、嗜睡和睡眠行为紊乱的类风湿性关节炎患者，必须考虑到可能发生阻塞性睡眠呼吸暂停。
