持续气道正压通气（CPAP）治疗下重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的6分钟步行试验数据。
6-Min walk-test data in severe obstructive-sleep-apnea-hypopnea-syndrome (OSAHS) under continuous-positive-airway-pressure (CPAP) treatment.
作者信息
Ben Saad Helmi, Ben Hassen Ikram, Ghannouchi Ines, Latiri Imed, Rouatbi Sonia, Escourrou Pierre, Ben Salem Halima, Benzarti Mohamed, Abdelghani Ahmed
机构信息
Research Laboratory LR14ES05: Interaction of the Cardiorespiratory System, Faculty of Medicine of Sousse, Sousse, Tunisia; Laboratory of Physiology, Faculty of Medicine, University of Sousse, Tunisia; Department of Physiology and Functional Explorations, Farhat HACHED Hospital, Sousse, Tunisia.
Pulmonary Department, Farhat HACHED Hospital, Sousse, Tunisia.
出版信息
Respir Med. 2015 May;109(5):642-55. doi: 10.1016/j.rmed.2015.03.001. Epub 2015 Mar 16.
INTRODUCTION
Few studies have evaluated the functional capacity of severe OSAHS.
AIMS
To assess their functional capacity, identify their 6-min walking-distance (6MWD) influencing factors and compare their data with those of two control-groups.
METHODS
Sixty (42 males) clinically consecutive stable patients with severe OSAHS under CPAP were included. Clinical, Epworth questionnaire, anthropometric, polysomnographic, plethysmographic and 6-min walk-test (6MWT) data were collected. Univariate and multivariate analyses were used to identify the 6MWD influencing factors. Data of a subgroup of severe OSAHS aged ≥40 Yrs (n = 49) were compared with those of non-obese (n = 174) and obese (n = 55) groups.
RESULTS
The means ± SD of age and apnea-hypopnea-index were, respectively, 49 ± 10 Yr and 62 ± 18/h. The profile of OSAHS patients carrying the 6MWT, was as follows: at the end of the 6MWT, 31% and 25% had, respectively, a high dyspnea (>5/10, visual analogue scale) and a low heart-rate (<60% of-maximal-predicted), 13% had an abnormal 6MWD (<lower-limit-of-normal), 13% had an oxy-hemoglobin saturation (oxy-sat) fall> 5 points and 3% stopped the walk. The factors that significantly influenced the 6MWD, explaining 80% of its variability, are included in the following equation: 6MWD (m) = 29.66 × first-second-forced-expiratory-volume (L) - 4.19 × Body-mass-index (kg/m(2)) - 51.89 × arterial-hypertension (0. No; 1. Yes) + 263.53 × Height (m) + 2.63 × average oxy-sat during sleep (%) - 51.06 × Diuretic-use (0. No; 1. Yes) - 20.68 × Dyspnea (NYHA) (0. No; 1. Yes) - 38.09 × Anemia (0. No; 1. Yes) + 5.79 × Resting oxy-sat (%) - 586.25. Compared with non-obese and obese groups, the subgroup of OSAHS has a significantly lower 6MWD [100 ± 9%, 100 ± 8% and 83 ± 12%, respectively).
CONCLUSION
Severe OSAHS may play a role in reducing the functional capacity.
引言
很少有研究评估重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）的功能能力。
目的
评估其功能能力，确定其6分钟步行距离（6MWD）的影响因素，并将其数据与两个对照组的数据进行比较。
方法
纳入60例（42例男性）临床上连续的重度OSAHS稳定患者，这些患者正在接受持续气道正压通气（CPAP）治疗。收集临床、爱泼华嗜睡量表问卷、人体测量、多导睡眠图、体积描记和6分钟步行试验（6MWT）数据。采用单因素和多因素分析来确定6MWD的影响因素。将年龄≥40岁的重度OSAHS亚组（n = 49）的数据与非肥胖组（n = 174）和肥胖组（n = 55）的数据进行比较。
结果
年龄和呼吸暂停低通气指数的平均值±标准差分别为49±10岁和62±18次/小时。进行6MWT的OSAHS患者的情况如下：在6MWT结束时，分别有31%和25%的患者有高度呼吸困难（>5/10，视觉模拟量表）和低心率（<最大预测值的60%），13%的患者6MWD异常（<正常下限），13%的患者氧合血红蛋白饱和度（氧饱和度）下降>5个百分点，3%的患者停止步行。显著影响6MWD并解释其80%变异性的因素包含在以下方程中：6MWD（米）=29.66×第一秒用力呼气量（升）-4.19×体重指数（千克/平方米）-51.89×动脉高血压（0.否；1.是）+263.53×身高（米）+2.63×睡眠期间平均氧饱和度（%）-51.06×利尿剂使用情况（0.否；1.是）-20.68×呼吸困难（纽约心脏协会分级）（0.否；1.是）-38.09×贫血（0.否；1.是）+5.79×静息氧饱和度（%）-586.25。与非肥胖组和肥胖组相比，OSAHS亚组的6MWD显著更低[分别为100±9%、100±8%和83±12%]。
结论
重度OSAHS可能在降低功能能力方面起作用。
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