Quadri F, Boni E, Pini L, Bottone D, Venturoli N, Corda L, Tantucci C
Unit of Respiratory Medicine, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Division of Internal Medicine, Spedali Civili of Brescia, P.zza Spedali Civili, 1, Brescia, Italy.
Respir Physiol Neurobiol. 2017 Feb;236:51-56. doi: 10.1016/j.resp.2016.11.004. Epub 2016 Nov 10.
Obstructive sleep apnea hypopnea (OSAH) is associated with decreased exercise tolerance and autonomic abnormalities and represents a risk for cardiovascular diseases. The aim of the study was to evaluate the effects of CPAP on cardiovascular autonomic abnormalities and exercise performance in patients with OSAH without changes in lifestyle and body weight during treatment.
Twelve overweight subjects with OSAH underwent anthropometric measures, autonomic cardiovascular and incremental symptom-limited cardio-respiratory exercise tests before and after two months of treatment with CPAP.
Lower frequency component of power spectrum of heart rate variability (59.5±24.2 msec vs 43.2±25.9 msec; p<0.05) and improvements of maximal workload (99.3±13.5 vs 108.3±16.8%pred.; p<0.05) and peak oxygen consumption (95.3±7.6 vs 105.5±7.9%pred.; p<0.05) were observed in these patients after CPAP, being their BMI unchanged.
CPAP-induced decrease of sympathetic hyperactivity is associated with better tolerance to the effort in OSAH patients that did not change their BMI and lifestyle, suggesting that OSAH limits per se the exercise capacity.
阻塞性睡眠呼吸暂停低通气（OSAH）与运动耐力下降和自主神经功能异常有关，是心血管疾病的一个危险因素。本研究的目的是评估持续气道正压通气（CPAP）对OSAH患者心血管自主神经异常和运动表现的影响，且治疗期间患者的生活方式和体重无变化。
12名超重的OSAH患者在接受CPAP治疗两个月前后，进行了人体测量、心血管自主神经功能以及递增症状限制心肺运动试验。
这些患者在接受CPAP治疗后，心率变异性功率谱的低频成分降低（59.5±24.2毫秒对43.2±25.9毫秒；p<0.05），最大负荷（99.3±1·3.5对108.3±16.8%预计值；p<0.05）和峰值耗氧量（95.3±7.6对105.5±7.9%预计值；p<0.05）有所改善，而其体重指数未改变。
CPAP引起的交感神经过度兴奋降低与BMI和生活方式未改变的OSAH患者对运动的更好耐受性相关，提示OSAH本身限制了运动能力。
