中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2012年
10期
1046-1049
,共4页
肖淑萍%马英文%朱海英%孙红玉
肖淑萍%馬英文%硃海英%孫紅玉
초숙평%마영문%주해영%손홍옥
阻塞性睡眠呼吸暂停低通气综合征%脑血管储备能力%经颅多普勒超声%二氧化碳吸入
阻塞性睡眠呼吸暫停低通氣綜閤徵%腦血管儲備能力%經顱多普勒超聲%二氧化碳吸入
조새성수면호흡잠정저통기종합정%뇌혈관저비능력%경로다보륵초성%이양화탄흡입
Obstructive sleep apnea-hypopnea syndrome%Cerebrovascular reserve capacity%Transcranial Doppler ultrasonography%Inhaling CO2
目的 评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者脑血管储备能力(CVR).方法 选择114例OSAHS患者和43名健康人作为研究对象.114例OSAHS患者根据呼吸暂停低通气指数(AHI)和夜间最低血氧饱和度(LSaO2)分为轻、中、重度组.对所有受试者均采用经颅多普勒超声检测仪和CO2分压检测仪,通过吸入自身CO2气体诱导高碳酸血症、过度换气诱导低碳酸血症的方法来测定脑血管储备功能.结果 中、重度OSAHS患者低碳酸血症时CVR分别为(1.80±1.34)、(1.43±1.05) ％/mm Hg明显低于健康对照组(2.93±0.93)％/mm Hg,差异均有统计学意义(P均＜0.05);轻度OSAHS患者CVR为(2.53±1.83)％/mm Hg,与健康对照组比较差异无统计学意义(P＞0.05).高碳酸血症时中、重度OSAHS患者CVR分别为(1.83±1.32)、(1.08±1.00) ％/mm Hg明显低于健康对照组(3.32±1.53) ％/mm Hg,差异均有统计学意义(P均＜0.05);AHI与低、高碳酸血症脑血管储备之间呈负相关(r值分别为-0.665、-0.721;P均＜0.05).结论 吸入CO2方法可用于CVR功能的评价.CVR与AHI相关.中、重度OSAHS患者由于缺氧严重,CVR能力降低使血流动力学发生变化.
目的 評價阻塞性睡眠呼吸暫停低通氣綜閤徵(OSAHS)患者腦血管儲備能力(CVR).方法 選擇114例OSAHS患者和43名健康人作為研究對象.114例OSAHS患者根據呼吸暫停低通氣指數(AHI)和夜間最低血氧飽和度(LSaO2)分為輕、中、重度組.對所有受試者均採用經顱多普勒超聲檢測儀和CO2分壓檢測儀,通過吸入自身CO2氣體誘導高碳痠血癥、過度換氣誘導低碳痠血癥的方法來測定腦血管儲備功能.結果 中、重度OSAHS患者低碳痠血癥時CVR分彆為(1.80±1.34)、(1.43±1.05) ％/mm Hg明顯低于健康對照組(2.93±0.93)％/mm Hg,差異均有統計學意義(P均＜0.05);輕度OSAHS患者CVR為(2.53±1.83)％/mm Hg,與健康對照組比較差異無統計學意義(P＞0.05).高碳痠血癥時中、重度OSAHS患者CVR分彆為(1.83±1.32)、(1.08±1.00) ％/mm Hg明顯低于健康對照組(3.32±1.53) ％/mm Hg,差異均有統計學意義(P均＜0.05);AHI與低、高碳痠血癥腦血管儲備之間呈負相關(r值分彆為-0.665、-0.721;P均＜0.05).結論 吸入CO2方法可用于CVR功能的評價.CVR與AHI相關.中、重度OSAHS患者由于缺氧嚴重,CVR能力降低使血流動力學髮生變化.
목적 평개조새성수면호흡잠정저통기종합정(OSAHS)환자뇌혈관저비능력(CVR).방법 선택114례OSAHS환자화43명건강인작위연구대상.114례OSAHS환자근거호흡잠정저통기지수(AHI)화야간최저혈양포화도(LSaO2)분위경、중、중도조.대소유수시자균채용경로다보륵초성검측의화CO2분압검측의,통과흡입자신CO2기체유도고탄산혈증、과도환기유도저탄산혈증적방법래측정뇌혈관저비공능.결과 중、중도OSAHS환자저탄산혈증시CVR분별위(1.80±1.34)、(1.43±1.05) ％/mm Hg명현저우건강대조조(2.93±0.93)％/mm Hg,차이균유통계학의의(P균＜0.05);경도OSAHS환자CVR위(2.53±1.83)％/mm Hg,여건강대조조비교차이무통계학의의(P＞0.05).고탄산혈증시중、중도OSAHS환자CVR분별위(1.83±1.32)、(1.08±1.00) ％/mm Hg명현저우건강대조조(3.32±1.53) ％/mm Hg,차이균유통계학의의(P균＜0.05);AHI여저、고탄산혈증뇌혈관저비지간정부상관(r치분별위-0.665、-0.721;P균＜0.05).결론 흡입CO2방법가용우CVR공능적평개.CVR여AHI상관.중、중도OSAHS환자유우결양엄중,CVR능력강저사혈류동역학발생변화.
Objective To assess cerebrovascular reserve capacity in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods One hundred and fourteen patients with OSAHS and 43 normal persons were enrolled in this study.The patients were divided into mild,moderate,severe according to apnea hypopnea index (AHI) and LSaO2 (lowest arterial oxygen saturation).All the patients and normal persons were routinely examined using transcranial Doppler (TCD) and end-tidal carbon dioxide partial pressure(ETCO2) to evaluate cerebrovascular reserve.Hypercapnia was induced by inhaling the CO2 which produced by the patients themselves,and hypocapnia was elicited by voluntary hyperventilation.Results CVR in the severe and moderate OSAHS were significantly lower than that in the control group [ (1.80 ± 1.34) ％/mm Hg and (1.43 ±1.05)％/mm Hg vs (2.93 ±0.93)％/mm Hg,P ＜0.05] when patients in the condition of hypocapnia.And there was no significant difference on CRV between the mild OSAHS group and control group [ (2.53 ±1.83 ) ％/mm Hg vs ( 2.93 ± 0.93 ) ％/mm Hg,P ＞ 0.05 ].When patients in the condition of Hypercapnia,CRV in the severe and moderate OSAHS were also significantly lower than that in the control group [ ( 1.83 ±1.32) ％/mm Hg and (1.08 ± 1.00)％/mm Hg vs (3.32 ± 1.53)％/mm Hg,P ＜ 0.05),AHI was negatively correlated with the cerebrovascular reserve at the condition of hypercapnia and hypocapnia (r=-0.665,-0.721; P ＜ 0.05 ).Conclusion Inhaling CO2 is a effective method for assessing CVR.Cerebrovascular reserve capacity is associated with AHI.Reduced CVR causes hemodynamics change being severe hypoxia in the moderate and severe OSAHS.
