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[减重手术对肥胖女性肺功能测试及阻塞性睡眠呼吸暂停的影响]

[EFFECTS OF WEIGHT LOSS AFTER BARIATRIC SURGERY ON PULMONARY FUNCTION TESTS AND OBSTRUCTIVE SLEEP APNEA IN MORBIDLY OBESE WOMEN].

作者信息

Santiago Ana, Carpio Carlos, Caballero Paloma, Martín-Duce Antonio, Vesperinas Gregorio, Gómez de Terreros Francisco, Gómez Mendieta M A, Álvarez-Sala Rodolfo, García de Lorenzo Abelardo

机构信息

Servicio de Neumología. Hospital Universitario La Paz. IdiPAZ. Departamento de Medicina y Cirugía. Universidad Autónoma de Madrid..

Servicio de Radiología. Hospital Universitario de La Princesa. Universidad Autónoma de Madrid..

出版信息

Nutr Hosp. 2015 Sep 1;32(3):1050-5. doi: 10.3305/nh.2015.32.3.9487.

Abstract

INTRODUCTION

obesity impacts on respiratory function and also it acts as a risk factor for obstructive sleep apnea (OSA).

AIMS

to study the effects of bariatric surgery on pulmonary function tests and on OSA in morbidly obese women over 4 years.

METHODS

fifteen morbidly obese women (mean body mass index [BMI] 50.52 ± 12.71 kg.m-2, mean age 40.13 ± 10.06 years) underwent pulmonary function tests (PFT) in two opportunities (before and after weight loss surgery). PFT included spirometry, body plethysmography and measure of maximal inspiratory mouth pressure (PImax) and of tension-time index for inspiratory muscles. Also, in both opportunities, resting arterial blood gas tensions were evaluated and a full night sleep register was performed.

RESULTS

BMI significantly decreased after bariatric surgery (-44.07 kg.m-2 [CI 95% -38.32 - -49.81]). Also, there was a significantly increase in forced expiratory volume in 1 second (FEV1) (p < 0.01), forced vital capacity (FVC) (p < 0.01), expiratory reserve volume (ERV) (p = 0.040), functional residual capacity (FRC) (p = 0.009) and a decline in airways resistance (Raw) (p = 0.018). Concerning sleep registers, apnea hypopnea index (p = 0.001) and desaturation index (p = 0.001) were also reduced after weight loss. Improve in ERV had a significant correlation with weight loss (r = 0.774, p = 0.024). Conclussions: pulmonary function tests and apnea hypopnea index improve after bariatric surgery in mor bidly obese women. Improvement of ERV is well correlated with weight loss.

摘要

引言

肥胖会影响呼吸功能,并且是阻塞性睡眠呼吸暂停(OSA)的一个危险因素。

目的

研究减肥手术对病态肥胖女性4年以上肺功能测试和阻塞性睡眠呼吸暂停的影响。

方法

15名病态肥胖女性(平均体重指数[BMI]50.52±12.71kg·m⁻²,平均年龄40.13±10.06岁)在两个时间点(减肥手术前后)接受了肺功能测试(PFT)。PFT包括肺活量测定、体容积描记法以及最大吸气口腔压力(PImax)和吸气肌张力 - 时间指数的测量。此外,在这两个时间点,均评估了静息动脉血气张力并进行了整夜睡眠记录。

结果

减肥手术后BMI显著降低(-44.07kg·m⁻²[95%置信区间-38.32 - -49.81])。此外,1秒用力呼气量(FEV1)(p<0.01)、用力肺活量(FVC)(p<0.01)、呼气储备量(ERV)(p = 0.040)、功能残气量(FRC)(p = 0.009)显著增加,气道阻力(Raw)下降(p = 0.018)。关于睡眠记录,减肥后呼吸暂停低通气指数(p = 0.001)和去饱和指数(p = 0.001)也降低了。ERV的改善与体重减轻有显著相关性(r = 0.774,p = 0.024)。结论:减肥手术可改善病态肥胖女性的肺功能测试和呼吸暂停低通气指数。ERV的改善与体重减轻密切相关。

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