CAJ | 학술논문

目的目的初步探讨阻塞性睡眠呼吸暂停综合征(OSAS)患者仰卧位肺功能和相关神经电生理指标及其相关性.方法将OSAS患者60例设为OSAS组,并根据呼吸暂停低通气指数将其分为轻度OSAS组15例、中度OSAS组18例和重度OSAS组27例共3个亚组,另选取30例无呼吸系统疾患的志愿者作为对照组.2组入选者均进行仰卧位肺功能及膈神经运动传导(PNC)检测.肺功能检测指标包括肺活量(VC)、第一秒用力呼气容积(FEV1)、最大通气量(MVV)及其占预计值的百分比、深吸气量(IC)、补呼气量(ERV).PNC检测记录潜伏期、膈肌复合动作电位(dCMAP).结果与对照组比较,OSAS组患者的VC%预计值、MVV%预计值、FEV1%预计值、IC以及ERV等差异均有统计学意义(P＜0.05).与对照组比较,轻度OSAS组患者仅FEV1%预计值与对照组比较差异有统计学意义(P＜0.01),其余各项2组间比较差异均无统计学意义(P＞0.05);中、重度OSAS组患者的肺功能各项指标与对照组比较,差异均有统计学意义(P＜0.01).OSAS组与对照组比较,2组间的PNC潜伏期差异无统计学意义(P＞0.05),而2组间的dCMAP波幅比率差异有统计学意义(P＜0.01).提示dCMAP波幅比率与VC%预计值、MVV%预计值、FEV1%预计值、ERV、IC呈正相关,与呼吸暂停低通气指数(AHI)呈负相关.结论 OSAS患者卧位肺功能存在异常,通过PNC检测可为OSAS患者提供膈肌功能障碍的信息.OSAS患者dCMAP波幅的减低可能与肺功能异常相关.
목적 목적초보탐토조새성수면호흡잠정종합정(OSAS)환자앙와위폐공능화상관신경전생리지표급기상관성.방법 장OSAS환자60례설위OSAS조,병근거호흡잠정저통기지수장기분위경도OSAS조15례、중도OSAS조18례화중도OSAS조27례공3개아조,령선취30례무호흡계통질환적지원자작위대조조.2조입선자균진행앙와위폐공능급격신경운동전도(PNC)검측.폐공능검측지표포괄폐활량(VC)、제일초용력호기용적(FEV1)、최대통기량(MVV)급기점예계치적백분비、심흡기량(IC)、보호기량(ERV).PNC검측기록잠복기、격기복합동작전위(dCMAP).결과 여대조조비교,OSAS조환자적VC%예계치、MVV%예계치、FEV1%예계치、IC이급ERV등차이균유통계학의의(P＜0.05).여대조조비교,경도OSAS조환자부FEV1%예계치여대조조비교차이유통계학의의(P＜0.01),기여각항2조간비교차이균무통계학의의(P＞0.05);중、중도OSAS조환자적폐공능각항지표여대조조비교,차이균유통계학의의(P＜0.01).OSAS조여대조조비교,2조간적PNC잠복기차이무통계학의의(P＞0.05),이2조간적dCMAP파폭비솔차이유통계학의의(P＜0.01).제시dCMAP파폭비솔여VC%예계치、MVV%예계치、FEV1%예계치、ERV、IC정정상관,여호흡잠정저통기지수(AHI)정부상관.결론 OSAS환자와위폐공능존재이상,통과PNC검측가위OSAS환자제공격기공능장애적신식.OSAS환자dCMAP파폭적감저가능여폐공능이상상관.
Objective To observe neurophysiological changes and pulmonary function in obstructive sleep apnea syndrome (OSAS) and analyze their inter-relationship. Methods Sixty OSAS patients were studied. Their lung function and phrenic motor nerve conduction (PNC) were examined. Thirty cases without respiratory disorder served as controls. The lung function tests included percentage of the predicted value of vital capacity ( VC% ), percentage of the predicted value of maximal voluntary ventilation ( MVV% ), percentage of the predicted value of forced expiratory volume in one second ( FEV1% ), inspiratory capacity ( IC), and expiratory reserve volume (ERV). The phrenic nerve was stimulated electrically, and the latent period and the diaphragmatic compound muscle action potential (dCMAP) were recorded. Results The VC%, MVV%, FEV1% , IC and ERV of the patients with OSAS were significantly lower than those of the controls. There was no significant difference between the patients and the controls with regard to their PNC latency. In the OSAS patients the amplitude ratio of their dCMAPs was positively correlated with VC% , MVV% , FEV1% , IC and ERV, and negatively with an apnea hypopnea index (AHI).Conclusions PNC examination can provide valuable information for evaluating diaphragmatic dysfunction in those with abnormal lung function. Decreased dCMAP might be associated with abnormal lung function.