南方医科大学学报 ›› 2012, Vol. 32 ›› Issue (12): 1727-.

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睡眠呼吸暂停综合征患者的持续气道正压通气治疗压力预测

韩建芳,李涛平,冯媛,李丹青,李晓琳,罗淼   

  • 出版日期:2012-12-20 发布日期:2012-12-20

Relationship of continuous positive airway pressure and pulmonary function in patients with obstructive sleep apnea-hypopnea syndrome

  • Online:2012-12-20 Published:2012-12-20

摘要: 目的探讨睡眠呼吸暂停低通气综合征患者持续气道正压通气治疗压力与其肺功能指标的关系,并简易预测有效的治疗
压力公式。方法回顾性分析48例确诊为OSAHS患者的临床资料,并行肺功能测定和人工气道压力滴定。观察指标包括治疗
压力和肺功能指标(潮气量、一秒量、中心气道阻力、外周气道阻力等)。行多元线性回归分析。结果睡眠呼吸暂停低通气综合
征患者的治疗压力与肺功能各项指标无相关关系,与颈围、腹围、睡眠呼吸暂停低通气指数、平均血氧饱和度、最低血氧饱和度、
氧降指数有相关关系。根据多元线性逐步回归(按α=0.05检验水准),只有氧降指数(P=0.002)和平均血氧饱和度(P=0.034)两
个变量进入以治疗压力为应变量的回归方程中,且有统计学意义。即治疗压力与氧降指数及平均血氧饱和度有线性回归关系,
与平均血氧饱和度呈负相关。结论睡眠呼吸暂停低通气综合征患者的治疗压力与肺功能无相关关系。预测公式为:有效
治疗压力=24.262+0.044×氧降指数-0.19×平均血氧饱和度,在无人工压力滴定的条件下可以通过此公式预测治疗压力。

Abstract: ObjectiveTo explore the relationship of continuous positive airway pressure and pulmonary function in patients
with obstructive sleep apnea hypopnea syndrome (OSAHS), and formulate the prediction equation for the effective
therapeutic pressure.MethodsIn a retrospective cross-sectional study of48patients with established OSAHS, all the patients
were carefully examined for their medical history, and overnight sleep monitoring was carried out to measure the sleep
apnea-hypopnea index, mean oxygen saturation, minimum oxygen saturation, and oxygen drop index. The data of manual
pressure titration (effective pressure) and pulmonary function tests (tidal volume, one second forced expiratory volume,
central airway resistance, and peripheral airway resistance were collected for multiple linear regression analysis.ResultsThe
effective therapeutic pressure was not correlated with the indices of the pulmonary functions in the patients, but showed
correlations with the neck circumference, abdominal circumference, apnea-hypopnea index, mean oxygen saturation, least
oxygen saturation, and oxygen desaturation index. Multiple linear regression (α=0.05 test level) identified only oxygen
desaturation index (P=0.012) and mean oxygen saturation (P=0.036) as the dependent variables of the effective therapeutic
pressure. Linear regression analysis showed that the effective therapeutic pressure had a linear relationship with the oxygen
drop index and mean oxygen saturation, and was inversely correlated with the mean oxygen saturation.ConclusionsIn
patients with OSAHS, the pulmonary function indices are not correlated with the effective therapeutic pressure. In the absence
of manual pressure titration, the effective therapeutic pressure can be predicted using the prediction equation: effective
therapy pressure =24.262+0.044×oxygen desaturation index -0.19×average oxygen saturation.