睡眠時呼吸障害における気道内圧測定と肥満度の関連

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Obstruction of various anatomical sites in the upper respiratory tract is known to cause obstructive sleep apnea hypopnea syndrome (OSAHS). Accurate diagnosis of responsible obstructive site is important in selecting effective surgical options. Severe degree OSAHS often accompanies obesity and this factor frequently complicates the treatmentprocess. We analyzed the data of polysomnography (PSG) and pharyngeal-esophageal pressure in relation with obstruction sites and body mass index (BMI). A total of 12 patients with sleep breathing disorder (SBD) were evaluated. Pharyngealesophageal pressure measurement was done during PSG. Average esophageal pressure was 28.5±10.9 cmH_2O and the average of maximum esophageal pressure was 65.4 ± 23.4cmH2O. Obstruction site was at soft palate in 8 cases and at base of tongue in 4 cases. The base of tongue often was the responsible obstruction site in the patient with severe degree OSAHS. Esophageal pressure and apnea hypopnea index (AHI) showed increasing correlation with BMI. Whereas, lowest SpO2 showed negative correlation. Pharyngeal-esophageal pressure might be elevated when the patient showed high BMI cases. OSAHS might not fall in severe degree in these cases. Base of tongue is responsible for the elevation of pharyngeal-esophageal pressure. Obesity can cause increasing obstruction at base of tongue. Accurate diagnosis of obstruction site and proper selection of surgical options are important for treating these cases.
愛知医科大学の論文
2005-06-10

睡眠時呼吸障害における気道内圧測定と肥満度の関連

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