抽象
很少有研究评估鼻持续气道正压(CPAP)对阻塞性睡眠呼吸暂停综合征的长期生理影响。因此,我们对CPAP治疗的患者肺功能、动脉血气和肺血流动力学的变化进行了前瞻性研究。65名患者被纳入研究。家庭治疗鼻CPAP的平均时间为64+/-6个月。在基线评估时,大多数患者(77%)是吸烟者。我们观察到1秒内用力呼气量(FEV1)从基线(t0)的80+/-21%下降到随访评估(t5)时预测值的76+/-21% (p<0.01)。动脉氧张力(P[a,O2])总体上保持稳定(9.4+/-1.5 kPa (71+/-11 mmHg),而9.4+/-1.2 kPa (71+/-9 mmHg)。低氧血症亚组患者t0 (n=23)时P(a,O2)升高,从7.8+/-0.7 kPa (59+/-5 mmHg)升高到8.9+/-1.2 kPa (67+/-9 mmHg)。各组动脉血二氧化碳张力(P[a,CO2])从5.2+/-0.7 kPa (39+/-5 mmHg)上升至5.4+/-0.5 kPa (41+/-4 mmHg),差异有统计学意义(P <0.05)。静息时肺动脉压(Ppa)无明显变化(16+/-5 mmHg vs 17+/-5 mmHg); NS) nor did exercising Ppa. In the 11 patients with pulmonary hypertension at t0, Ppa was 24+/-5 mmHg at t0 versus 20+/-7 mmHg at t5 (NS). We conclude that the significant decrease of forced expiratory volume in one second after 5 yr follow-up was related to a high percentage of smokers and exsmokers in the study population. Daytime arterial oxygen tension and pulmonary artery pressure remained stable in an unselected series of 65 obstructive sleep apnoea syndrome patients treated for 5 yrs with nasal continuous positive airway pressure, unlike arterial carbon dioxide tension, which increased by a small, but significant, amount.