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[目的]探讨及研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的运动心肺功能变化期发现心血管疾病的机理。[方法]将2005年2月～2007年4月入住我院的OSAHS患者35例设为观察组,分别对两组进行静态肺功能检查,测定用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、FEV50及FEV25;采用多导睡眠监测仪(PSG)进行监测,测定呼吸紊乱指数(AHI)和最低血氧饱和度(LSaO2);并进行心肺运动试验(CEPT),监测心电图、血压、SpO2、氧耗量(Vo2)、每分钟通气量(VE)及无氧阈(AT)等;另设20例健康人为对照组,进行与观察组同样的PSG和心肺运动试验的测定。[结果]观察组FVC、FEVl、FVC%pred、FEV1%pred、FE25及FEF50与对照组比较有显著性差异(P﹤0.05,P﹤0.01);观察组最大氧耗量(Vo2max)、最大运动负荷(Wmax)及无氧阈(AT)均低于对照组,两组比较有显著差异(P﹤0.05);心率明显高于对照组,有显著差异(P﹤0.01)。观察组OSAHS患者运动心肺功能指标与疾病严重程度的相关性分析显示最大氧脉搏、最大运动负荷及无氧阈与呼吸紊乱指数呈负相关(P﹤0.01),Vo2max、Wmax及AT与夜间最低血氧饱和度呈正相关(P﹤0.05),Vo2max、Wmax及AT与心率呈正相关(P﹤0.05)。[结论]与健康人相比,长期反复发生的夜间低氧血症与OSAHS患者心肺功能的下降相关,即低氧的时间越长,血氧饱和度越低,心肺功能受损越严重。因此,采用心肺运动试验(CPET)评价可判断OSAHS患者心肺病变进行治疗的合适时机。
[Objective] To investigate and study the mechanism of cardiovascular disease found in the changes of cardiopulmonary function during obstructive sleep apnea-hypopnea syndrome (OSAHS). [Methods] Totally 35 OSAHS patients admitted to our hospital from February 2005 to April 2007 were enrolled in the observation group. Static pulmonary function tests were performed on the two groups. The forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV50 and FEV25. The polysomnography (PSG) was used to monitor the respiratory disturbance index (AHI) and the lowest oxygen saturation (LSaO2). Cardiopulmonary exercise test (CEPT), electrocardiogram , SpO2, oxygen consumption (Vo2), ventilation rate per minute (VE) and anaerobic threshold (AT), etc .; another 20 healthy people as the control group, the observation group with the same PSG and cardiopulmonary exercise test determination. [Results] There were significant differences in FVC, FEV1, FVC% pred, FEV1% pred, FE25 and FEF50 between the observation group and the control group (P <0.05, P <0.01) (Wmax) and anaerobic threshold (AT) were lower than the control group, there was significant difference between the two groups (P <0.05); heart rate was significantly higher than the control group, there was significant difference (P <0.01). Correlation analysis between the index of cardiopulmonary function and the severity of the disease showed that the maximal oxygen pulse, maximal exercise load and anaerobic threshold were negatively correlated with the index of respiratory disorder (P <0.01), while Vo2max, Wmax and AT were the lowest in night Oxygen saturation was positively correlated (P <0.05), while Vo2max, Wmax and AT were positively correlated with heart rate (P <0.05). [Conclusion] The long-term recurrence of nocturnal hypoxemia is associated with the decline of cardiopulmonary function in OSAHS patients compared with healthy people. The longer the hypoxia time, the lower the oxygen saturation and the more severe the cardiopulmonary function. Therefore, the use of cardiopulmonary exercise test (CPET) evaluation of OSAHS patients can determine the appropriate timing of treatment of cardiopulmonary disease.