肥胖青少年阻塞性睡眠呼吸暂停综合征患者上气道临界压的变化及其临床意义

doi:10.13481/j.1671-587x.20150520

吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (05): 990-993.doi: 10.13481/j.1671-587x.20150520

肥胖青少年阻塞性睡眠呼吸暂停综合征患者上气道临界压的变化及其临床意义

袁海波¹, 张征骄², 张艳秋³, 彭丽萍¹, 华树成¹

1. 吉林大学第一医院呼吸内科, 吉林长春 130021;
2. 吉林省人民医院神经内科, 吉林长春 130021;
3. 吉林大学第二医院心血管内科导管室, 吉林长春 130041

收稿日期:2015-04-06 出版日期:2015-09-28 发布日期:2015-09-29
通讯作者: 华树成,教授,博士研究生导师(Tel:0431-88782399,E-mail:63086636@qq.com) E-mail:63086636@qq.com
作者简介:袁海波(1976-),女,吉林省长春市人,主治医师,医学博士,主要从事睡眠呼吸暂停综合征病因学方面的研究。
基金资助:
国家自然科学基金资助课题(81300062)

Changes of pharyngeal critical pressure in obese adolescents with obstructive sleep apnea syndrome and its clinical significance

YUAN Haibo¹, ZHANG Zhengjiao², ZHANG Yanqiu³, PENG Liping¹, HUA Shucheng¹

1. Department of Respiratory Medicine, First Hospital, Jilin University, Changchun 130021, China;
2. Department of Neurology, People's Hospital, Jilin Province, Changchun 130021, China;
3. Conduit Room, Department of Cardiovascular Medicine, Second Hospital, Jilin University, Changchun 130041, China

Received:2015-04-06 Online:2015-09-28 Published:2015-09-29

摘要/Abstract

摘要：

目的:观察肥胖青少年阻塞性睡眠呼吸暂停综合征(OSAS)患者上气道临界压(Pcrit)的变化,探讨其在青少年人群OSAS发病中的作用机制。方法:根据多导睡眠监测数据和体质量指数(BMI),将受试者分为肥胖OSAS组(n=16)、肥胖对照组(n=18)和正常体质量对照组(n=17)。在多导睡眠监测的基础上,应用上气道压力-气流流量分析技术计算3组受试者的压力-气流曲线斜率和Pcrit。并分析上气道压力气流曲线斜率与睡眠呼吸暂停指数(AHI)及上Pcrit与AHI的相关性。结果:肥胖OSAS组受试者上气道压力-气流曲线斜率和上气道临界压明显高于肥胖对照组和正常体质量对照组(P<0.01);肥胖对照组受试者Pcrit低于正常体质量对照组(P<0.05)。肥胖OSAS组受试者上气道压力-气流曲线斜率与AHI呈正相关关系(r=0.789,P=0.005);Pcrit与AHI呈正相关关系(r=0.654,P=0.032)。结论:Pcrit的增高是肥胖青少年OSAS上气道阻塞的原因之一;肥胖且非OSAS青少年的Pcrit的维持对预防上气道阻塞有重要作用。

关键词: 青少年, 阻塞性睡眠呼吸暂停综合征, 上气道临界压

Abstract:

Objective To observe the changes of pharyngeal critical pressure (Pcrit) in the obese adolescents with obstructive sleep apnea syndrome (OSAS),and to investigate the role of Pcrit in the pathogenesis of OSAS in the adolescents. Methods According to the results from polysomnography and body mass index (BMI) measurements,the subjects were divided into obese OSAS group (n=16),obese control group (n=18),and lean control group (n=17).On the base of polysomnography monitoring,the slope of pressure-flow curve and Pcrit were observed by pressure-flow relationship technology.Then the relationship between Pcrit and apnea hypopnea index (AHI) was analyzed. Results The slope of pressure-flow curve and Pcrit of patients in obese OSAS group were significantly higher than those in obese control group and lean control group (P<0.01);the Pcrit of objects in obese control group was lower than that in lean control group (P<0.05).In obese OSAS group,the positive correlation was found between the slope of pressure-flow curve and AHI (r=0.789,P=0.005),as well as Pcrit and AHI (r=0.654,P=0.032). Conclusion The increase of Pcrit is one of the reasons for upper airway obstruction in the obese adolescents with OSAS.To maintain Pcrit is important for the obese adolescents without OSAS to protect the upper airway from occlusion.

Key words: adolescent, obstructive sleep apnea syndrome, pharyngeal critical pressure

中图分类号:

R562

袁海波, 张征骄, 张艳秋, 彭丽萍, 华树成. 肥胖青少年阻塞性睡眠呼吸暂停综合征患者上气道临界压的变化及其临床意义[J]. 吉林大学学报(医学版), 2015, 41(05): 990-993.

YUAN Haibo, ZHANG Zhengjiao, ZHANG Yanqiu, PENG Liping, HUA Shucheng. Changes of pharyngeal critical pressure in obese adolescents with obstructive sleep apnea syndrome and its clinical significance[J]. Journal of Jilin University Medicine Edition, 2015, 41(05): 990-993.

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肥胖青少年阻塞性睡眠呼吸暂停综合征患者上气道临界压的变化及其临床意义

Changes of pharyngeal critical pressure in obese adolescents with obstructive sleep apnea syndrome and its clinical significance

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