Valera Sánchez A, Capote Gil F, Ramos Ruiz A, Rodríguez Becerra E, Castillo Gómez J
Servicio de Neumología, Hospital Universitario Virgen del Rocío, Sevilla.
Med Clin (Barc). 1993 Jun 19;101(4):128-31.
The aim of this study was to evaluate the right ventricular function in the obstructive apnea sleep syndrome (OSAS) and to determine the effect of the continuous use of a continuous positive pressure nasal device on the airway (CPSPn) produces on this aspect of the disease.
Forty patients were diagnosed of OSAS by study of spontaneous night sleep. A functional respiratory study was performed in all the patients as was a calculation of the index of body mass (IBM) and isotopic ventriculography for the calculation of the right and left ventricular ejection fractions (RVEF and LVEF). Twenty-six patients were followed after 8.4 +/- 3.3 months of home treatment with CPAPn in which these studies were repeated.
Twenty-four of the 40 patients (60%) had RVEF lower than 0.45. These 24 patients had paO2 in vigil state (69.9 +/- 13.6 mmHg) than those with a normal RVEF (80.1 +/- 8.7 mmHg) (p < 0.05). After treatment with CPAPn an elevation was observed in the RVEF in the group which was followed. This increase was significant in the subgroup sharing low RVEF (n = 16) prior to starting treatment upon passing from 0.39 (+/- 0.02) to 0.45 (+/- 0.04) (p < 0.001).
Right ventricular dysfunction in frequent in patients with the obstructive apnea sleep syndrome and is more frequent in patients maintaining hypoxemia in vigil. The continual use of continuous positive pressure in the nasal airway produces improvement in right ventricular function particularly in those in whom this was most disturbed.
本研究的目的是评估阻塞性睡眠呼吸暂停综合征（OSAS）患者的右心室功能，并确定持续使用鼻腔持续气道正压通气装置（CPSPn）对该疾病这一方面的影响。
通过对夜间自然睡眠的研究，诊断出40例OSAS患者。对所有患者进行了功能性呼吸研究、计算体重指数（IBM）以及进行同位素心室造影以计算右心室和左心室射血分数（RVEF和LVEF）。26例患者在接受8.4±3.3个月的CPAPn家庭治疗后进行随访，并重复上述研究。
40例患者中有24例（60%）的RVEF低于0.45。这24例患者清醒状态下的动脉血氧分压（69.9±13.6 mmHg）低于RVEF正常的患者（80.1±8.7 mmHg）（p<0.05）。接受CPAPn治疗后，随访组的RVEF有所升高。在治疗开始前RVEF较低的亚组（n=16）中，这种升高更为显著，从0.39（±0.02）升至0.45（±0.04）（p<0.001）。
阻塞性睡眠呼吸暂停综合征患者常出现右心室功能障碍，且在清醒时维持低氧血症的患者中更为常见。持续使用鼻腔持续气道正压通气可改善右心室功能，尤其是在右心室功能受影响最严重的患者中。
