重度阻塞性睡眠呼吸暂停低通气综合征患者的肺功能分析
Analysis of pulmonary function in patients with severe obstructive sleep apnea-hypopnea syndrome

目的 ·探讨重度阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的肺功能变化。方法 ·以打鼾就诊并通过整夜多导睡眠（PSG）监测，达到重度OSAHS的患者入选为研究对象，选取PSG检查正常的自愿者作为对照组。2组均行肺功能检查，选取用力肺活量（FVC）、一秒用力呼出容积（FEV1）、FEV1/FVC、肺总量（TLC）实/预（实测值与预计值比值）、50%肺活量流速（PEF50）实/预、最大呼气中段流速（MMEF）实/预、一氧化碳弥散量（DLCO）实/预、气道总阻力（R5）实/预作为研究指标，对比2组指标差异有无统计学意义。结果 · 2组肺功能指标FVC、FEV1、FEV1/FVC、TLC实/预、DLCO实/预、R5实/预差异均无统计学意义，MMEF实/预（P=0.036)、PEF50实/预（P=0.043)差异有统计学意义。结论 ·重度OSAHS患者早期肺功能损害主要表现为小气道病变，应进行小气道功能监测，避免肺功能损害进一步加重。
： Objective · To investigate the changes in pulmonary function for patients with severe obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods · Snoring patients who reached severe OSAHS by whole night polysomnogram (PSG) monitoring were enrolled and volunteers with normal PSG results were selected as controls. Both groups underwent pulmonary function tests. Research indexes included FVC, FEV1, FEV1/FVC, ratio of TLC measured value to predicted value, ratio of PEF50 measured value to predicted value, ratio of MMEF measured value to predicted value, ratio of R5 measured value to predicted value, and ratio of DLCO measured value to predicted value. The differences in indexes between two groups were compared. Results · The differences in FVC, FEV1, FEV1/FVC, ratio of TLC measured value to predicted value, ratio of DLCO measured value to predicted value, and ratio of R5 measured value to predicted value were not statistically significant. The differences in ratio of MMEF measured value to predicted value (P=0.036) and ratio of PEF50 measured value to predicted value (P=0.043) were statistically significant. Conclusion · Early pulmonary function damage in patients with severe OSAHS is mainly small airway disease. Small airway function should be monitored to avoid further aggravation of pulmonary function