The Study Of Obstructive Sleep Apnea Hypopnea Syndrome And Pulmonary Hypertension

Objective:1. To study the incident of pulmonary hypertension or cor pulmonale in patients with obstructive sleep apnea-hypopnea syndrome and the relation between respiratory disturbance events with pulmonary hypertension, predictive its value on pulmonary hypertension.2. To examine the long-term effects of continuous positive airway pressure therapy on pulmonary pressure and Right ventricular free wall thickness in OSAHS with pulmonary hypertension.Methods:1. Study subjects were389patients with OSAHS in the absence of other cardiac or lung diseases, and underwent color Doppler echocardiography.389patients were divided into control group of298cases and pulmonary hypertension (PAH) group of91cases. The respiratory disturbance events were compared with two groups.2. The OSAHS with pulmonary hypertension who consent to the CPAP treatment was divided into three groups:①mild pulmonary hypertension;②The Moderate-severe pulmonary hypertension;③pulmonary heart disease group:pulmonary hypertension with the changes of right heart structural. the pulmonary artery systolic pressure and right ventricular wall thickness changes with this three group were compared before and after treatment.Results:1. Pulmonary hypertension was found in91cases (23%) of patients with OSAHS without lung disease or other diseases that can induce pulmonary hypertension.2. A significantly higher TST-SpO2<80%in PAH group as compared to Control group,average SpO2and lowest SpO2was significantly lower than the control group, which reached statistically significant (P<0.05); no significant difference between the PAH and Control group were observed regarding TST-SpO2<90%(P>0.05).3. A significantly higher TST-A, AHI and maximum desaturation in PAH group as compared to Control group(P<0.05); no significant difference between the PAH and Control group were observed regarding TST-HY (P>0.05). 4. Using binary logistic regression analysis suggest that the TST-A,AHI, the average SpO2can be independent risk factors for pulmonary hypertension.5. Apnea hyponea index and average SpO2have Changed after1month and3months in the patients with pulmonary hypertension(P<0.05), But pulmonary artery systolic pressure have significant changed after3months in the patients with pulmonary hypertension(P>0.05).6. Pulmonary artery systolic pressure and right ventricular anterior wall thickness had no significant improved after CPAP treatment1month in Patients with cor pulmonale.(P>0.05), but had significant improved after CPAP treatment3months(P<0.05).Conclusion:1. OSAHS was an independant risk factor for the pulmonary hypertension, The prevalent of pulmonary hypertension and cor pulmonale were23%,9.8%, respectively.2. TST-A, AHI, the average SpO2were independant risk factors for the pulmonary hypertension in OSAHS.3. For the combined pulmonary hypertension and (or) pulmonary heart disease in patients with OSAHS, CPAP was an effective means to reduce pulmonary artery pressure and improve right heart structure.