Hart T B, Radow S K, Blackard W G, Tucker H S, Cooper K R
Arch Intern Med. 1985 May;145(5):865-6.
Previous case reports have shown an association between acromegaly and the sleep apnea syndrome (SAS). Some of the patients described had central SAS, raising the possibility that an elevation of the growth hormone (GH) level may cause a defect in respiratory drive. We determined the prevalence of SAS in 21 patients with a history of acromegaly. We separated them into two groups based on serum GH concentrations. Ten patients had active acromegaly (mean GH concentration, 62.2 ng/mL; range, 12.6 to 148 ng/mL), while 11 patients had inactive acromegaly (mean GH, 3.2 ng/mL; range, 0.7 to 6.4 ng/mL). Four of the ten patients with active acromegaly had SAS; none of the 11 patients with inactive acromegaly had SAS. Three patients with SAS had the purely obstructive type, and one had the mixed central and obstructive type. The hypercapnic ventilatory response was normal in all patients tested and was not influenced by the GH level. We conclude that SAS is associated with active acromegaly and that the GH level does not affect the hypercapnic ventilatory response. The absence of SAS in successfully treated patients suggests that it may resolve after a normal GH level is restored.
既往病例报告显示肢端肥大症与睡眠呼吸暂停综合征（SAS）之间存在关联。部分所描述的患者患有中枢性SAS，这增加了生长激素（GH）水平升高可能导致呼吸驱动缺陷的可能性。我们确定了21例有肢端肥大症病史患者的SAS患病率。根据血清GH浓度将他们分为两组。10例患者患有活动性肢端肥大症（平均GH浓度为62.2 ng/mL；范围为12.6至148 ng/mL），而11例患者患有非活动性肢端肥大症（平均GH为3.2 ng/mL；范围为0.7至6.4 ng/mL）。10例活动性肢端肥大症患者中有4例患有SAS；11例非活动性肢端肥大症患者中无一例患有SAS。3例患有SAS的患者为单纯阻塞型，1例为中枢性与阻塞性混合型。所有接受测试的患者高碳酸通气反应均正常，且不受GH水平影响。我们得出结论，SAS与活动性肢端肥大症相关，且GH水平不影响高碳酸通气反应。成功治疗的患者中未出现SAS表明，在GH水平恢复正常后SAS可能会缓解。
