中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2013年
7期
490-492
,共3页
王慧玲%魏翠英%吕云辉%董霄松%李静%安培%赵龙%韩芳
王慧玲%魏翠英%呂雲輝%董霄鬆%李靜%安培%趙龍%韓芳
왕혜령%위취영%려운휘%동소송%리정%안배%조룡%한방
睡眠呼吸暂停综合征,阻塞性%高碳酸血症%持续气道正压通气
睡眠呼吸暫停綜閤徵,阻塞性%高碳痠血癥%持續氣道正壓通氣
수면호흡잠정종합정,조새성%고탄산혈증%지속기도정압통기
Sleep apnea syndrome,obstructive%Hypercapnia%Continuous positive airway pressure
目的 分析OSAHS患者日间高碳酸血症的发生情况及其相关因素.方法 收集2007-2009年就诊于北京大学人民医院,并进行了日间血气分析检查的OSAHS患者共1441例,了解日间高碳酸血症(PaCO2≥45 mm Hg,1 mm Hg=0.133 kPa)的发生率.对测定了肺功能且不存在明显阻塞性通气功能障碍(FEV1/FVC>70%)的145例患者根据PaCO2水平分为高碳酸血症组(PaCO2≥45 mm Hg)和不伴高碳酸血症组(PaCO2 <45 mm Hg),比较二组的性别、年龄、体重指数、肺功能指标、多导睡眠图(PSG)指标和血气分析值,通过直线回归分析获得PaCO2与其他变量的相关性.结果 在未经选择的OSAHS人群中,伴有日间高碳酸血症的发生率为25.2%,除外阻塞性通气功能障碍后,单纯OSAHS患者日间高碳酸血症的发生率为26.9%.伴高碳酸血症组与不伴高碳酸血症组中体重指数、FEV1/FVC%、夜间平均SpO2、夜间最低SpO2存在显著差异.在直线回归分析中,体重指数、PaO2、夜间平均SpO2、SIT90与PaCO2相关(r=1.990、-2.283、-3.023,P<0.05).结论 约1/4的OSAHS患者存在日间高碳酸血症,CO2潴留可以发生在无明显气流阻塞的患者,与体重指数、PaO2、夜间平均SpO2、SIT90与OSAHS患者合并日间高碳酸血症密切相关.
目的 分析OSAHS患者日間高碳痠血癥的髮生情況及其相關因素.方法 收集2007-2009年就診于北京大學人民醫院,併進行瞭日間血氣分析檢查的OSAHS患者共1441例,瞭解日間高碳痠血癥(PaCO2≥45 mm Hg,1 mm Hg=0.133 kPa)的髮生率.對測定瞭肺功能且不存在明顯阻塞性通氣功能障礙(FEV1/FVC>70%)的145例患者根據PaCO2水平分為高碳痠血癥組(PaCO2≥45 mm Hg)和不伴高碳痠血癥組(PaCO2 <45 mm Hg),比較二組的性彆、年齡、體重指數、肺功能指標、多導睡眠圖(PSG)指標和血氣分析值,通過直線迴歸分析穫得PaCO2與其他變量的相關性.結果 在未經選擇的OSAHS人群中,伴有日間高碳痠血癥的髮生率為25.2%,除外阻塞性通氣功能障礙後,單純OSAHS患者日間高碳痠血癥的髮生率為26.9%.伴高碳痠血癥組與不伴高碳痠血癥組中體重指數、FEV1/FVC%、夜間平均SpO2、夜間最低SpO2存在顯著差異.在直線迴歸分析中,體重指數、PaO2、夜間平均SpO2、SIT90與PaCO2相關(r=1.990、-2.283、-3.023,P<0.05).結論 約1/4的OSAHS患者存在日間高碳痠血癥,CO2潴留可以髮生在無明顯氣流阻塞的患者,與體重指數、PaO2、夜間平均SpO2、SIT90與OSAHS患者閤併日間高碳痠血癥密切相關.
목적 분석OSAHS환자일간고탄산혈증적발생정황급기상관인소.방법 수집2007-2009년취진우북경대학인민의원,병진행료일간혈기분석검사적OSAHS환자공1441례,료해일간고탄산혈증(PaCO2≥45 mm Hg,1 mm Hg=0.133 kPa)적발생솔.대측정료폐공능차불존재명현조새성통기공능장애(FEV1/FVC>70%)적145례환자근거PaCO2수평분위고탄산혈증조(PaCO2≥45 mm Hg)화불반고탄산혈증조(PaCO2 <45 mm Hg),비교이조적성별、년령、체중지수、폐공능지표、다도수면도(PSG)지표화혈기분석치,통과직선회귀분석획득PaCO2여기타변량적상관성.결과 재미경선택적OSAHS인군중,반유일간고탄산혈증적발생솔위25.2%,제외조새성통기공능장애후,단순OSAHS환자일간고탄산혈증적발생솔위26.9%.반고탄산혈증조여불반고탄산혈증조중체중지수、FEV1/FVC%、야간평균SpO2、야간최저SpO2존재현저차이.재직선회귀분석중,체중지수、PaO2、야간평균SpO2、SIT90여PaCO2상관(r=1.990、-2.283、-3.023,P<0.05).결론 약1/4적OSAHS환자존재일간고탄산혈증,CO2저류가이발생재무명현기류조새적환자,여체중지수、PaO2、야간평균SpO2、SIT90여OSAHS환자합병일간고탄산혈증밀절상관.
Objectives To evaluate the incidence and factors related to daytime CO2 retention (PaCO2 ≥45 mm Hg,1 mm Hg =0.133 kPa)in Chinese patients with obstructive sleep apnea hypopnea syndrome.Methods 1441 patients with OSAHS had daytime arterial blood gas analysis were recruited from 2007 to 2009 in Peking University People' s Hospital.145 patients underwent pulmonary function test and had FEV1/FVC ratio over 70% were under further analysis.Sex,age,BMI,pulmonary function,polysomnography (PSG)and blood gas analysis results were recorded.Linear regression analysis wasused to evaluate the relationship between PaCO2 levels and related parameters.Comparison was done between hypercanpnic and eucapnic patients.Results Daytime hypercapnia occuredin 25.2% of the 1441 patients with OSAHS,and 26.9% in the 145 OSAHS patients who had lung function test and with FEV1/FVC ratio over 70%.PaCO2 was correlated with BMI,PaO2 and the severity of nocturnal hypoxemia as reflected by the mean SpO2 and SIT90.This was also confirmed by the comparison between the hypercapnic and eucapnic patients.Conclusions Hypercapnia occurrs in a large part of patients with OSAHS and normal FEV1/FVC.BMI,nocturnal hypoxemia and daytime PaO2 level are all contributedto the development of daytime CO2 retention in OSAHS.