Laaban J P, Orvoen-Frija E, Cassuto D, Pascal S, Léger D, Basdevant A, Rochemaure J, Guy-Grand B
Service de Pneumologie et Réanimation, Hôtel-Dieu, Paris.
Presse Med. 1996;25(1):12-6.
The prevalence and mechanisms of diurnal hypercapnia in subjects with sleep apnea syndrome are not well known, particularly in the morbidly obese.
We studied a group of 24 subjects with sleep apnea syndrome and morbid obesity defined as a body mass index greater than 40 kg/m2 and free of chronic respiratory disease.
Hypercapnia (PaCO2 > 42 mmHg) was found in 50% of the subjects. Age, body mass index, waist/hip ratio, apnea index, ratio of maximum forced expiratory volume in one second (FEV1) to vital capacity and expiratory reserve volume were not significantly different between hypercapnic and normocapnic subjects. Total pulmonary capacity, vital capacity and FEV1 were significantly lower in hypercapnic subjects than in normocapnic subjects.
These findings suggest that ventilatory restriction plays an important role in the development of diurnal alveolar hypoventilation in subjects with sleep apnea syndrome and morbid obesity.
睡眠呼吸暂停综合征患者日间高碳酸血症的患病率及机制尚不清楚，尤其是在病态肥胖者中。
我们研究了一组24名睡眠呼吸暂停综合征且病态肥胖的受试者，病态肥胖定义为体重指数大于40kg/m²且无慢性呼吸系统疾病。
50%的受试者存在高碳酸血症（动脉血二氧化碳分压>42mmHg）。高碳酸血症组与正常碳酸血症组受试者在年龄、体重指数、腰臀比、呼吸暂停指数、一秒用力呼气容积（FEV1）与肺活量及呼气储备容积之比方面无显著差异。高碳酸血症组受试者的肺总量、肺活量和FEV1显著低于正常碳酸血症组受试者。
这些发现表明，通气受限在睡眠呼吸暂停综合征和病态肥胖受试者日间肺泡通气不足的发生中起重要作用。
