超重及肥胖对OSA患者肺功能的影响分析

王金凤; 张琼; 谢宇平; 褚媛媛; 马薇; 惠培林; 苏晓艳; 郭斌; 刘瑜

doi:10.13201/j.issn.1001-1781.2019.07.009

超重及肥胖对OSA患者肺功能的影响分析

- 1 甘肃省人民医院睡眠中心(兰州, 730000);
- 2 武威市人民医院呼吸科;
- 3 甘肃省人民医院心内2科
基金项目:
国家自然科学基金 (No:81560228)

2018甘肃省卫生和计划生育委员会项目 (No:1290)

2018年甘肃省人民医院院内基金项目 (No:18GSSY4-19)

2016年甘肃省卫生行业科研计划项目 (No:GSWSKY2016-07)

2015年甘肃省重大疾病调查研究项目 (No:2015-01)

详细信息

通讯作者: 谢宇平,E-mail:xyp5894@163.com

中图分类号: R563.8

收稿日期: 2018-10-02

Analysis of the overweight and obesity effects on pulmonary function in OSA patients

- 1 Sleep Medicine Center, Gansu Provincial People's Hospital, Lanzhou, 730000, China;
- 2 Department of Respiratory, the People's Hospital of Wuwei;
- 3 Department of Cardiology, Gansu Provincial People's Hospital

More Information

Corresponding author: XIE Yu-ping, E-mail: xyp5894@163.com

Received Date: 02 October 2018

摘要

摘要: 目的:探讨超重及肥胖对OSA患者肺功能的影响。方法:随机选取2017-01-2017-12期间收治的90例OSA患者,依据BMI分为3个组,每组30例:正常OSA组(A组)、超重OSA组(B组)及肥胖OSA组(C组)。对比分析各组年龄、AHI、夜间最低血氧饱和度(LSaO₂)、最长呼吸暂停时间(LAD);肺功能各项指标包括:一秒量(FEV1)、用力肺活量(FVC)、FEV1/FVC、最大通气量(MVV)、每分静息通气量(MV)、呼气峰值流速(PEF)、潮气量(VT)、残气容积、功能残气量(FRC)、补呼气容积(ERV)、肺总量(TLC)、肺活量(VC)、深吸气量(IC)、残气量比肺总量。结果:C组较A组和B组及B组较A组,AHI显著增加(P<0.01);C组较A组和B组,LSaO₂显著降低(P<0.01);C组较A组LAD显著延长(P<0.05)。C组较A组,MVV、MV、TLC、IC显著增加(P<0.05),FRC、ERV显著减低(P<0.05);C组较B组,MVV、MV及TLC显著增加(P<0.05)。B组较A组,MVV、MV、75%肺活量时最大呼气流速、ERV及IC显著增加(P<0.05);AHI与VT、RV、TLC及FRC呈显著正相关(P<0.05),与VT、MVV及FEV1/FVC呈显著负相关(P<0.05);LAD与BMI、VC、FVC、FEV1、50%肺活量时最大呼气流速、PEF及MVV呈显著正相关(P<0.05),其中FEV1/ FVC、IC是超重、肥胖OSA病情严重性的独立影响因子。结论:随着BMI的增加,不仅出现OSA严重程度增加,而且出现肺功能进一步损害;超重及肥胖OSA患者的严重程度与多项肺功能指标密切相关;FEV1/FVC、IC为超重及肥胖OSA患者严重程度的独立影响因子。肺功能可作为超重及肥胖OSA患者病情严重程度的辅助评估检查。
- 睡眠呼吸暂停 /
- 阻塞性 /
- 多导睡眠监测 /
- 肺功能
Abstract: Objective: To investigate the overweight and obesity effects on pulmonary function in OSA patients. Method: Randomly selected 90 cases OSA patients who were treated January 2017 to December 2017. On the basis of BMI were divided into three groups, the normal OSA group(A, 30 cases), overweight OSA group(B, 30 cases) and obesity OSA group(C, 30 cases). Comparative analysis between groups of age, AHI, lowest arterial saturation oxygen(LSaO₂), the longest apnea time(LAD) and pulmonary function indicators include: a second volume(FEV1), forced vital capacity(FVC), FEV1/FVC, the chase volume(MVV), per minute resting ventilation(MV), peak expiratory flow velocity(PEF), tidal volume(VT), the residual gas volume(RV), functional residual capacity(FRC) and expiratory reserve volume volume(ERV), total lung volume(TLC) vital capacity(VC), deep inspiratory capacity(IC), RV/TLC. Result: Compared group C with B and A, B and A, AHI increased significantly(P<0.01); compared group C with B and A, LSaO₂significantly reduced(P<0.01); compared group C with A, LAD is prolonged(P<0.05). Compared group C with A, MVV, MV, TLC and IC increased significantly(P<0.05), FRC, ERV significantly reduced(P<0.05); compared C with B, MVV, MV and TLC increased significantly(P<0.05). Compared group B with A, MVV, MV, MEF 75, ERV and IC increased significantly(P<0.05); AHI and VT, RV, TLC and FRC has significant positive correlation(P<0.05), and VT, MVV and FEV1/FVC has significant negative correlation(P<0.05); LAD with BMI, VC, FVC, FEV1, MEF 50, PEF and MVV is a significant positive correlation(P<0.05). FEV1/FVC, IC is the independence of overweight and obesity OSA severe impact factor. Conclusion: With the increasing of BMI, not only increase the severity of OSA, and further damage to the pulmonary function; the OSA severity of overweight and obesity are closely associated with multiple pulmonary function index; FEV1 % FVC, IC for overweight and obesity independent factor influencing the severity of OSA. Pulmonary function can be used as overweight and obesity auxiliary to assess the severity of OSA patients.
- sleep apnea /
- obstructive /
- polysomnography /
- pulmonary function

HTML全文

参考文献(11)

[1]	中国医师协会睡眠医学专业委员会.成人阻塞性睡眠呼吸暂停征诊治指南[J].中华医学杂志, 2018, 24 (98):1902-1914.
[2]	DACAL QUINTAS R, TUMBEIRO NOVOA M, ALVES PÉREZ M T, et al.Obstructive sleep apnea in normal weight patients:characteristics and comparison with overweight and obese patients[J].Arch Bronconeumol, 2013, 49:513-517.
[3]	DIXON A E, PETERS U.The effect of obesity on lung function[J].Expert Rev Respir Med, 2018, 12:755-767.
[4]	LANDRY S A, JOOSTEN S A, ECKERT D J, et al.Therapeutic CPAP Level Predicts Upper Airway Collapsibility in Patients With Obstructive Sleep Apnea[J].Sleep, 2017, 40:56-57.
[5]	AZARBARZIN A, SANDS S A, TARANTO-MONTEMURRO L, et al.Collapsibility during sleep by peak inspiratory airflow[J].Sleep, 2017, 40:43-46.
[6]	BIKOV A, LOSONCZY G, KUNOS L, et al.Role of lung volume and airway inflammation in obstructive sleep apnea[J].Respir Investig, 2017, 55:326-333.
[7]	BEHAZIN N, JONES S B, COHEN R I, et al.Respiratory restriction and elevated pleural and esophageal pressures in morbid obesity[J].J Appl Physiol, 2010, 108:212-218.
[8]	BOSTANCI A, BOZKURT S, TURHAN M, et al.Impact of age on intermittent hypoxia in obstructive sleep apnea:apropensity-matched analysis[J].Sleep Breath, 2018, 22:317-322.
[9]	XU Y N, LI J, HUANG J Y, et al.Effect of obstructive sleep apnea on sleep architecture of acute ischemic stroke patients[J].Zhonghua Yi Xue Za Zhi, 2017, 97:920-924.
[10]	WU X, LIU Z, CHANG S C, et al.Screening and managing obstructive sleep apnoea in nocturnal heart block patients:an observational study[J].Respir Res, 2016, 17:16-16.
[11]	TURHAN M, BOSTANCI A, BOZKURT S, et al.Estimation of cardiovascular disease from polysomnographic parameters in sleep-disordered breathing[J].Eur Arch Otorhinolaryngol, 2016, 273:4585-4593.