中国耳鼻咽喉头颈外科2018，Vol.25Issue(7)：375-379,5.DOI:10.16066/j.1672-7002.2018.07.008
阻塞性睡眠呼吸暂停低通气综合征患者呼吸调控稳定性对持续正压通气治疗效果的影响
Predictive value of ventilatory steability in determining positive airway pressure efficacy in patients with obstructive sleep apnea
摘要
Abstract
OBJECTIVE We hypothesized that unstable ventilatory control(high loop gain, LG) could predict the short-term efficacy of positive airway pressure therapy in patients with obstructive sleep apnea(OSA). METHODS 42 adult patients with OSA, M/F=39/3, were studied. The stability of the ventilatory control system(LG) was quantified by fitting a simplified mathematical model to the spontaneous ventilatory pattern obtained via polysomnography. LG, pulmonary function test results, and other PSG parameters were analyzed in patients who had post-treatment AHI≥10 events/hr(non-responders) using auto-positive airway pressure therapy. RESULTS The subjects aged(40±8) years, apnea-hypopnea index(AHI) were 68.2[42.9,81.0]events/hr). Nine patients(34.6％) were non-responders. Twenty pat ients(47.6％) had residual AHI＜5 events/hr. Loop gain and pre-treatment mixed apnea index were higher in the non-responders versus responders(0.74 [0.62, 0.82] vs 0.49[0.37, 0.77], P =0.035) and(11.0[4.3, 22.9] vs 2.0[0.2, 5.3], P =0.004). In the 26 patients with LG＞0.6, nine(34.9％) had posttreatment 5 events/hr≤AHI＜10 events/hr. And all of the non-responders had LG(n=9, 34.9％). The difference was signif icant between the LG＞0.6 a nd LG＜0.6 group(P =0.007). CONCLUSION Loop gain and mixed apnea index was higher in patients with residual AHI＞10 events/hr after short-term auto-PAP therapy. Ventilatory control stability evaluation might have predictive value for PAP treatment efficacy in OSA patients.关键词
睡眠呼吸暂停/阻塞性/连续气道正压通气/呼吸功能试验/环路增益Key words
Sleep Apnea/Obstructive/Respiratory Function Tests/positive airway pressure/loop gain引用本文复制引用
李彦如,丁秀,郜飞,杨庆文,王小轶,徐文,韩德民..阻塞性睡眠呼吸暂停低通气综合征患者呼吸调控稳定性对持续正压通气治疗效果的影响[J].中国耳鼻咽喉头颈外科,2018,25(7):375-379,5.基金项目
国家重点研发计划(2017YFC0112500)和首都医科大学附属北京同仁医院科研骨干基金(2017-YJJ-GGL-006)联合资助 （2017YFC0112500）
