CAJ | 학술논문

肥胖低通气综合征是指由肥胖导致的日间的慢性通气不足.其发病机制包括睡眠呼吸紊乱,呼吸驱动力减低以及与肥胖相关的呼吸系统受损等,并有显著的发病率和病死率.治疗方法主要包括正压通气、减肥及药物治疗等.但是,由于缺乏大规模的研究对各种疗法进行评估,限制了循证推荐治疗的发展进程.针对改善睡眠呼吸紊乱的治疗通常是有效的,但并非所有患者都能够忍受面罩通气,且尽管有效,但清醒状态下的高碳酸血症可能会持续存在.从更长远的角度来说,减肥是可取的,但是缺乏其在治疗肥胖肺通气不足的成功率和持续性的数据.这篇文章主要阐述肥胖低通气综合征的主要机制、临床表现及目前的治疗方案.
비반저통기종합정시지유비반도치적일간적만성통기불족.기발병궤제포괄수면호흡문란,호흡구동력감저이급여비반상관적호흡계통수손등,병유현저적발병솔화병사솔.치료방법주요포괄정압통기、감비급약물치료등.단시,유우결핍대규모적연구대각충요법진행평고,한제료순증추천치료적발전진정.침대개선수면호흡문란적치료통상시유효적,단병비소유환자도능구인수면조통기,차진관유효,단청성상태하적고탄산혈증가능회지속존재.종경장원적각도래설,감비시가취적,단시결핍기재치료비반폐통기불족적성공솔화지속성적수거.저편문장주요천술비반저통기종합정적주요궤제、림상표현급목전적치료방안.
Obesity hypoventilation syndrome is the association between obesity and the development of chronic daytime alveolar hypoventilation. This syndrome caused by the a complex interaction between sleep-disordered breathing, diminished respiratory drive and obesity-related respiratory impairment,and is associated with significant morbidity and mortality. Therapy directed toward reversing these abnormalities and to improved daytime breathing,with available treatment options including positive pressure therapy,weight loss,and pharmacological management.However,due to the lack of large-scale,well-designed studies evaluating these various therapies has limited the development of evidence-based treatment recommendations. Although treatment directed toward improving sleepdisordered breathing is usually effective,not all patients tolerate mask ventilation and awake hypercapnia may persist despite effective use.In the longer term,weight loss is desirable,but data on the success and sustainability of this approach in obesity hypoventilation are still insufficient.This abstract outlines the main mechanisms, clinical presentations and current therapy options of the obesity hypoventilation syndrome.