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題名:嚴重阻塞性睡眠呼吸中止症患者其呼吸道發炎反應與肺功能之探討     (16點)
Investigation of Airway Inflammation and Pulmonary Function in Patients with Severe Obstructive Sleep Apnea
著者:林珮君(Pei-Chun Lin) ;李佩玲(Pei-Lin Lee) ;吳惠東(Hui-Dung Wu) ;莊雅惠(Ya-Hui Chuang) ;王儷穎(Li-Ying Wang)
出版地區:台灣
出版城市:台北市
學科:物理 ; 醫學綜合
關鍵字:阻塞性睡眠呼吸中止症 ; 發炎反應 ; 肺功能 ; Obstructive sleep apnea ; Inflammation ; Pulmonary function
刊名:物理治療
卷期:35卷1期(2010.3)
頁碼:16-23
語言:繁體中文
摘要: 中文摘要PDF ; 英文摘要PDF

背景與目的:阻塞性睡眠呼吸中止症(obstructive sleep apnea, OSA) 之病徵為週期性重覆發生的上 呼吸道阻塞。患者常合併全身性及呼吸道局部發炎之現象,但其與肺功能之間的關係尚不清楚。 本研究目的為藉由誘發疲液之方式評估重度OSA 患者之呼吸道發炎程度,並探討發炎及疾病嚴重 度對肺功能的影響。方法:本研究招募20 位平均年齡為50 , 35::!::8 , 95 歲、具重度OSA 診斷之自願 受試者。以肺量計測試評估其肺功能;另以誘發疲液檢體分析其呼吸道發炎程度。統計以皮爾森 相關係數( Pearson correlation coefficient) 評估參數聞之相關性。結果:受試者平均用力吐氣肺容 量(FVC) 與平均第一秒用力吐氣量(FEV] )均在正常範圍內,分別為預測值之102.72::!::1 L1 0% 及 97.78::!::12.03% ;兩者之比值(FEV]/FVC) 則為77. 20::!::3 .43% ;平均用力吐氣中段流連(FEF25_75 )較 低,為預測值之68.70::!:: 14 .40% 。疲液之平均細胞濃度為2.01 土1. 37 X 106 個/毫升,嗜中性球比例 為59.20::!::20.949志,巨噬細胞比例為30.04::!:: 20.679忘。AHI 指數( apnea hypopnea index, AHI )和~液 中嗜中性球比例呈顯著中度正相關( r=0.45, p<0.05 ) ;和疲液中之巨噬細胞比例則呈現顯著中度負 相關( r=-0.45, p<0.05 ) 。但發炎指標與肺功能之間均無顯著相關。結論:本研究結果顯示重度OSA 之患者其呼吸道存在發炎反應,其發炎特徵為有較高比例的嗜中性球與較低比例的巨噬細胞。患 者之疾病嚴重度與呼吸道發炎程度具中度相關。患者較低之FEF25_75 顯示長期追蹤OSA 患者其小氣 道功能變化有其必要性。(物理治療2010;35(1):16-23 )
Background and Purpose: Obstructive sleep apnea (OSA) is characterized by episodes of repetitive upper airway obstruction during sleep. Evidence of both systemic and airway inflammation had been found in patients with OSA. However, the relationship between airway inflammation and pulm凹的function remains unclear. The objective of this study were (1) to evaluate the degree of airway inflammation by induced sputum in patients with severe OSA, and (2) to investigate the correlations between airway inflammation, disease severity, and pulmonary function parameters. Methods: Twenty treatment-naÏve patients with severe OSA (mean age: 50.35:t8.95 y/o) were recruited. Spirometry was used to evaluate pulmonary function and airway inflammation was assessed by induced sputum. Pearson correlation coefficient was used to explore the correlations between parameters. Results: The mean FVC (1 02.72:t11.1O% of predicted) and FEV1 (97.78:t12.03% of predicted) of all subjects were within normal range, and the mean FEV/FVC ratio was 77.20:t3.43%. Compared to healthy population, the FEF25_75 was relatively low in patients with severe OSA (68.70:t14.40% of predicted). The mean cell concentration in induced sputum was 2.01:t1.37x106cells/ml. The neutrophil and macrophage percentage in induced sputum was 59.20:t20.94% and 30.04:t20.67%, respectively. Significant positive correlation between AHI and neutrophil percentage was found (r=0.45, p<0.05), and AHI was negatively correlated with macrophage percentage (r=-0.45, p<0.05). No significant correlation was found between inflammatory markers and pulmonary function parameters in the study population. Conclusions: Airway inflammation existed in patients with severe OSA, which was characterized by a higher neutrophil and a lower macrophage percentage. Disease severity was found to moderately correlate with airway inflammation. Lower FEF25_75 predicted value suggested that it is necessary to evaluate the small airway function of these patients longitudinally. (FJPT 2010;35(1):16-23)


    

本卷期目次
物理治療 35卷1期 (2010.3)
台灣老人身體活動能力與日常生活功能之階層相關探討/ 葉婷婷王靜怡林志峰陳惠雅
嚴重阻塞性睡眠呼吸中止症患者其呼吸道發炎反應與肺功能之探討/ 林珮君李佩玲吳惠東莊雅惠王儷穎
前十字韌帶重建術後穿戴膝護具之必要性探討--系統性回顧與統合分析/ 邱馨儀高宜暄郭曉縈陳佳琳施怡芬李雪楨陳文英
運動訓練對周邊動脈疾病患者周邊循環之療效:系統回顧與統合分析/ 趙婉茹吳英黛劉千綺
發展性舞蹈運動訓練對於發展障礙兒童的動作精練程度之影響:可行性報告/ 劉文瑜陳怡蓁彭曼筠黃維彬林燕慧連恒裕
中華民國物理治療學會第六十次學術研討會--論文摘要/ 陽明大學
原發性肺動脈高壓患者運動能力與生活品質相關因素之探討/ 蕭淑芳吳英黛徐紹勛賴玉玫
 
   
 
   

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