Stauffer J L, White D P, Zwillich C W
Department of Medicine, Pennsylvania State University, Milton S. Hershey Medical Center, Hershey.
Chest. 1990 Feb;97(2):302-7. doi: 10.1378/chest.97.2.302.
Reduction in the size of the pharynx and increased pharyngeal airflow resistance have been demonstrated in patients with obstructive sleep apnea (OSA). We evaluated 15 men with severe OSA and 10 nonapneic control subjects matched for age and weight in order to determine if PCSA, inspiratory pharyngeal airflow resistance, and abnormal breathing events during sleep were associated with alterations in the flow-volume relationship and other awake PFTs. Pharyngeal cross-sectional area was determined by CT, and pharyngeal resistance between choanae and epiglottis was measured during quiet awake breathing. In patients with OSA, there was an inverse relationship between the mean cross-sectional area of the oropharynx and the ratio of FEF50%/FIF50% (rs = -0.54; p = 0.03). In all subjects, pharyngeal resistance was inversely related to percentage of predicted values for FEF25-75% (rs = -0.56; p = 0.01). The frequency of apneas during sleep was significantly (p less than 0.05) related to the percentage of predicted values for MVV, TLC, FVC, and PIF. Obesity appears to account for the strength of these relationships. Flow-volume loops and other PFTs did not distinguish patients with OSA from controls.
阻塞性睡眠呼吸暂停（OSA）患者已被证实存在咽部尺寸减小和咽部气流阻力增加的情况。我们评估了15名重度OSA男性患者以及10名年龄和体重匹配的无呼吸暂停对照受试者，以确定咽部横截面积（PCSA）、吸气性咽部气流阻力以及睡眠期间异常呼吸事件是否与流量-容积关系和其他清醒时的肺功能测试（PFTs）改变相关。通过CT确定咽部横截面积，并在安静清醒呼吸期间测量鼻后孔与会厌之间的咽部阻力。在OSA患者中，口咽平均横截面积与FEF50%/FIF50%比值之间存在负相关（rs = -0.54；p = 0.03）。在所有受试者中，咽部阻力与FEF25 - 75%预测值百分比呈负相关（rs = -0.56；p = 0.01）。睡眠期间呼吸暂停的频率与MVV、TLC、FVC和PIF预测值百分比显著相关（p小于0.05）。肥胖似乎是这些关系强度的原因。流量-容积环和其他PFTs无法区分OSA患者和对照者。
