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评估治疗后的肢端肥大症患者的睡眠呼吸暂停综合征及其严重程度与临床和实验室参数的相关性。

Assessment of sleep apnea syndrome in treated acromegalic patients and correlation of its severity with clinical and laboratory parameters.

机构信息

Endocrine Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Viale Pieraccini, 6-50139 Florence, Italy.

出版信息

J Endocrinol Invest. 2013 Apr;36(4):237-42. doi: 10.3275/8513. Epub 2012 Jul 9.

DOI:10.3275/8513
PMID:22776855
Abstract

BACKGROUND

Sleep apnea syndrome (SAS) is a frequent disorder in acromegalic patients and its frequency ranges from 45 to 87.5% of patients. Obstructive SAS is the prevailing form in acromegaly and its pathogenesis is based on craniofacial deformations and thickening of soft tissues and mucosas of upper airways and bronchi. Central and mixed types are less frequent. Respiratory complications, and SAS in particular, may contribute to the increased mortality observed in acromegaly.

AIM

Aim of the present study is to assess the presence of SAS in acromegalic patients, its features and to correlate the severity of SAS with factors such as disease duration, body mass index (BMI), smoking, GH/IGF-I serum levels, associated comorbidities.

SUBJECTS AND METHODS

Polygraphy (SOMNOcheck Effort Weinmann V2.05) was performed in 25 consecutive acromegalic patients (9 men and 16 women). Statistical analysis was performed with Mann-Whitney's test and Spearman coefficient.

RESULTS

Fourteen out of 25 patients (56%) were affected by SAS. The prevailing form was obstructive SAS (12/14 patients). Smoking, female gender, and presence of lung disease appear to lead to a more severe form. We also found that the prevalence of hypertension was significantly higher in the group of patients with SAS, whereas no correlation was proved among SAS and disease duration, GH/IGF-I serum levels, somatostatin analogs treatment, BMI, and associated comorbidities.

CONCLUSIONS

SAS is a frequent complication of acromegaly. Severe forms seem to be correlated with smoking and lung disease. Therefore, all acromegalic patients should be subjected to a polygraphic study for an early diagnosis and treatment and smoking should be discouraged.

摘要

背景

睡眠呼吸暂停综合征(SAS)是肢端肥大症患者常见的疾病,其发病率在 45%至 87.5%之间。在肢端肥大症中,阻塞性 SAS 是主要的形式,其发病机制基于颅面畸形以及上呼吸道和支气管的软组织和粘膜增厚。中枢性和混合性 SAS 则较为少见。呼吸并发症,特别是 SAS,可能导致肢端肥大症患者死亡率增加。

目的

本研究旨在评估肢端肥大症患者中 SAS 的存在、特征,并将 SAS 的严重程度与疾病持续时间、体重指数(BMI)、吸烟、GH/IGF-I 血清水平、相关合并症等因素相关联。

对象和方法

对 25 例连续肢端肥大症患者(9 名男性和 16 名女性)进行多导睡眠图检查(SOMNOcheck Effort Weinmann V2.05)。统计分析采用 Mann-Whitney 检验和 Spearman 系数。

结果

25 例患者中有 14 例(56%)患有 SAS。主要形式为阻塞性 SAS(14 例中的 12 例)。吸烟、女性性别和肺部疾病的存在似乎导致了更为严重的形式。我们还发现,SAS 组的高血压患病率明显更高,而 SAS 与疾病持续时间、GH/IGF-I 血清水平、生长抑素类似物治疗、BMI 和相关合并症之间未发现相关性。

结论

SAS 是肢端肥大症的常见并发症。严重形式似乎与吸烟和肺部疾病有关。因此,所有肢端肥大症患者都应进行多导睡眠图检查,以便早期诊断和治疗,并应劝阻吸烟。

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