Zirlik Sabine, Schahin Simin Pour, Premm Wolfgang, Hahn Eckhart G, Fuchs Florian S
Department of Medicine 1, University of Erlangen-Nuremberg, Ulmenweg 18, Erlangen, Germany.
Respir Physiol Neurobiol. 2009 Sep 30;168(3):303-5. doi: 10.1016/j.resp.2009.06.018. Epub 2009 Jul 2.
Former studies suggested that lung volumes might play a role in pathomechanisms of obstructive sleep apnea (OSA). Mean apnea duration (MAD) is a rarely investigated parameter in OSA but is possibly a surrogate of arousal threshold. The aim of this study was to evaluate the influence of lung volumes to MAD in OSA. In 69 patients with obstructive sleep apnea (51 male und 18 female, BMI 34.2+/-6.0 kg/m(2), age 53.6+/-9.7 years, AHI 43.1+/-21.1/h) we performed a polysomnography and pulmonary function testing in daytime. There was a significant correlation between MAD and residual volume (RV) (r=0.51; p<0.001), which was the highest correlation we found. In linear regression analysis RV remained the only independent variable with significant influence on MAD (p<0.001). We could show that RV seems to play a role in the mechanisms of apnea termination in terms of MAD. MAD reflects the time until a specific negative intrathoracic pressure is reached to induce an arousal. In this process dependency on RV could explain our results. Despite some limitations these results provide some new aspects in understanding pathophysiology of OSA.
以往研究表明,肺容量可能在阻塞性睡眠呼吸暂停(OSA)的发病机制中起作用。平均呼吸暂停持续时间(MAD)是OSA中一个很少被研究的参数,但可能是觉醒阈值的一个替代指标。本研究的目的是评估肺容量对OSA患者MAD的影响。对69例阻塞性睡眠呼吸暂停患者(51例男性,18例女性,BMI 34.2±6.0kg/m²,年龄53.6±9.7岁,AHI 43.1±21.1次/小时)进行了多导睡眠图检查和白天肺功能测试。MAD与残气量(RV)之间存在显著相关性(r = 0.51;p < 0.001),这是我们发现的最高相关性。在线性回归分析中,RV仍然是对MAD有显著影响的唯一独立变量(p < 0.001)。我们可以证明,就MAD而言,RV似乎在呼吸暂停终止机制中起作用。MAD反映了达到特定的胸腔内负压以诱发觉醒所需的时间。在此过程中对RV的依赖性可以解释我们的结果。尽管存在一些局限性,但这些结果为理解OSA的病理生理学提供了一些新的方面。