Brzecka A, Zukowska H, Weryńska B
Katedry i Kliniki Chorób Pluc A.M. we Wroclawiu.
Pol Merkur Lekarski. 1996 Jul;1(1):8-10.
Among 30 patients with obstructive sleep (OSA) syndrome in 15% (50%) chronic alveolar hypoventilation developed; chronic hypercapnia was found in patients with mildly (7), moderately (2) and severely (6 patients) impaired lung ventilatory function. All patients with chronic hypercapnia were morbidly obese (BMI 44 +/- 12). Nocturnal polysomnography showed similar mean apnea duration in the groups of hypercapnic and eucapnic patients, longer duration of the longest apneas in hypercapnia (88 +/- 42 s) than in eucapnia (38 +/- 19 s), p < 0.01 and more severe desaturation during sleep (the mean of the lowest SaO2 during apneas 0.46 +/- 0.17 mol/mol) in hypercapnic and 0.71 +/- 0.11 mol/mol in eucapnic patients, p < 0.001). Polycythemia was found in 14 patients, exclusively in hypercapnia.
Chronic alveolar hypoventilation develops in some obese patients with impaired-even mildly or moderately-lung ventilatory function and with the most severe OSA syndrome, in which apneas may occasionally be extremely long and lead to very low saturation during sleep. Polycythemia occurs in most patients with chronic alveolar hypoventilation and OSA syndrome.
在30例阻塞性睡眠呼吸暂停(OSA)综合征患者中,15%(50%)出现慢性肺泡低通气;在肺通气功能轻度(7例)、中度(2例)和重度(6例)受损的患者中发现慢性高碳酸血症。所有慢性高碳酸血症患者均为病态肥胖(BMI 44±12)。夜间多导睡眠图显示,高碳酸血症组和正常碳酸血症组的平均呼吸暂停持续时间相似,但高碳酸血症组最长呼吸暂停持续时间(88±42秒)长于正常碳酸血症组(38±19秒),p<0.01,且睡眠期间高碳酸血症患者的去饱和更严重(呼吸暂停期间最低SaO2平均值为0.46±0.17摩尔/摩尔),正常碳酸血症患者为0.71±0.11摩尔/摩尔,p<0.001。14例患者发现红细胞增多症,均仅见于高碳酸血症患者。
慢性肺泡低通气在一些肺通气功能受损(即使是轻度或中度)且患有最严重OSA综合征的肥胖患者中发生,其中呼吸暂停偶尔可能极长,并导致睡眠期间饱和度极低。大多数慢性肺泡低通气和OSA综合征患者会出现红细胞增多症。