McNicholas W T, Coffey M, Fitzgerald M X
Thorax. 1986 Oct;41(10):777-82. doi: 10.1136/thx.41.10.777.
Ventilation and gas exchange during overnight sleep was studied in a group of seven patients with severe interstitial lung disease (mean vital capacity 50%, mean diffusing capacity 46% predicted), to see whether clinically significant oxygen desaturation occurred. Patients with a history of loud snoring or clinically significant airflow obstruction were excluded. Sleep was fragmented in these patients, but all achieved rapid eye movement (REM) sleep. All patients showed episodes of oxygen desaturation during sleep--mean (SEM) awake arterial oxygen saturation (SaO2) was 92.9% (0.3%) compared with a mean minimum SaO2 during sleep of 83.2% (2.1%) (p less than 0.01). These episodes were, however, transient, and mean SaO2 showed only a slight fall between wakefulness and sleep (non-REM 91.5%, REM 90.4%; NS). Furthermore, SaO2 during non-REM sleep correlated well (p less than 0.001) with SaO2 during wakefulness. Respiratory frequency showed a significant fall between wakefulness and sleep--21.1 (1.8) versus 17.3 (1.5) breaths per minute (p less than 0.02). Our data suggest that nocturnal oxygen treatment need not be considered in patients with interstitial lung disease unless the level of oxygenation while they are awake indicates the need for such treatment.
对一组7例重症间质性肺疾病患者（平均肺活量为预计值的50%，平均弥散量为预计值的46%）进行了夜间睡眠期间的通气和气体交换研究，以观察是否发生具有临床意义的氧饱和度下降。排除有打鼾史或具有临床意义的气流阻塞患者。这些患者的睡眠是碎片化的，但均进入了快速眼动（REM）睡眠。所有患者在睡眠期间均出现氧饱和度下降情况——清醒时动脉血氧饱和度（SaO2）平均值（标准误）为92.9%（0.3%），而睡眠期间最低SaO2平均值为83.2%（2.1%）（p<0.01）。然而，这些情况是短暂的，清醒和睡眠之间平均SaO2仅略有下降（非快速眼动睡眠期为91.5%，快速眼动睡眠期为90.4%；无显著性差异）。此外，非快速眼动睡眠期的SaO2与清醒时的SaO2相关性良好（p<0.001）。呼吸频率在清醒和睡眠之间显著下降——分别为每分钟21.1次（1.8次）和17.3次（1.5次）呼吸（p<0.02）。我们的数据表明，间质性肺疾病患者除非清醒时的氧合水平表明需要夜间氧疗，否则无需考虑进行夜间氧疗。
