Hayes Don, Daniels Curt J, Kirkby Stephen, Kopp Benjamin T, Nicholson Kerri L, Nance Ashley E, Splaingard Mark L
Department of Pediatrics, The Ohio State University, Columbus, OH, USA,
Lung. 2014 Jun;192(3):413-9. doi: 10.1007/s00408-014-9573-x. Epub 2014 Mar 27.
Pulmonary hypertension (PH) commonly occurs in patients with cystic fibrosis (CF), but there is no current data regarding alterations of sleep in patients with PH.
A single-center, retrospective review was performed in patients with advanced lung disease due to CF who completed both nocturnal polysomnography and right heart catheterization (RHC) from January 2010 to June 2013. For statistical analysis, two-tailed unpaired t tests and Pearson correlation coefficient analysis were performed after normal distribution was confirmed.
A total of 18 consecutive CF patients were enrolled with RHC identifying PH in 56 % (10/18) of patients. The PH group had significantly lower mean sleep efficiency (72 ± 4 vs. 87 ± 3 %, p = 0.01), significantly higher ETCO(2) levels (54.5 ± 2.2 vs. 43.8 ± 3.0 mmHg, p = 0.01) on capnography, and significantly lower PO(2) (53.8 ± 3.1 vs. 65.5 ± 3.9 mmHg, p = 0.03) on capillary blood gas. Correlations with poor sleep efficiency included mean PAP (r = - 0.55, p = 0.01), systolic PAP (r = -0.5, p = 0.03), ETCO(2) (r = - 0.53, p = 0.02), and PO(2)) (r = 0.62, p = 0.01); ETCO(2) with systolic PAP (r = 0.47, p = 0.04) and PCO(2) (r = - 0.57, p = 0.01); and PO(2) to 6-min walk distance (r = 0.55, p = 0.02).
We found significant differences in sleep efficiency and gas exchange associated with PH in CF patients with advanced lung disease.
肺动脉高压（PH）常见于囊性纤维化（CF）患者，但目前尚无关于PH患者睡眠改变的数据。
对2010年1月至2013年6月期间因CF导致晚期肺部疾病且完成夜间多导睡眠图和右心导管检查（RHC）的患者进行单中心回顾性研究。进行统计分析时，在确认正态分布后进行双尾非配对t检验和Pearson相关系数分析。
共纳入18例连续的CF患者，RHC显示56%（10/18）的患者存在PH。PH组的平均睡眠效率显著降低（72±4%对87±3%，p=0.01），二氧化碳图上的ETCO₂水平显著升高（54.5±2.2对4十三条±3.0 mmHg，p=0.01），毛细血管血气分析中的PO₂显著降低（53.8±3.1对65.5±3.9 mmHg，p=0.03）。与睡眠效率差相关的因素包括平均肺动脉压（r=-0.55，p=0.01）、收缩期肺动脉压（r=-0.5，p=0.03）、ETCO₂（r=-0.53，p=0.02）和PO₂（r=0.62，p=0.01）；ETCO₂与收缩期肺动脉压（r=0.47，p=0.04）和PCO₂（r=-0.57，p=0.01）；以及PO₂与6分钟步行距离（r=0.55，p=0.02）。
我们发现晚期肺部疾病的CF患者中，与PH相关的睡眠效率和气体交换存在显著差异。
