Studies on the Appearance of Pulsus Paradoxus and its Slignificance in Sleep Apnea Syndrome.

在科学研究补助金(C)期间取得的研究成果概述如下。总结了有关反常脉搏发生率的临床结果，并利用脉搏血氧仪(用赠款购买)进行了一项24小时测量SaO2水平的新研究。[1]反常脉搏发生率及其意义的研究在我们转诊的145例门诊患者中(1992年71例，1993年74例)，有66例入院接受更详细的检查或治疗。呼吸暂停类型阻塞性呼吸暂停61例，中央型呼吸暂停5例。40例阻塞性睡眠呼吸暂停综合征患者在提供OUT研究目的的完整信息后获得知情同意。结果：1)40例患者中，26例(1992年13/21例，1993年13/19例)出现脉搏反常；2)非快速眼动SL…时，脉搏反常发生率较高更多的eEP与呼吸受阻时PES的显著减少相吻合。3)有反常脉搏的患者较无反常脉搏患者明显年轻，PES明显降低。(4)鼻腔持续正压治疗可明显改善呼吸模式，使PES恢复正常，缓解脉搏反常。综上所述，阻塞性睡眠呼吸暂停综合征的发生率为65%，因此阻塞性睡眠呼吸暂停综合征作为PES过度减少的征象具有重要的临床意义。鼻腔CPAP治疗被认为对SAS患者PES的过度下降是有效的。[2]心血管疾病患者SaO2水平24小时变化的研究。使用研究基金购买的脉搏血氧仪每天24小时监测SaO2水平的变化。结果：1)夜间SaO2随功能恶化而降低，提示24小时SaO2监测可能是一种有用的心功能评价方法。2)Fallt四联症患者24小时SaO2水平呈反常变化，白天高于白天。较少

Research results obtained during the periods of Grant-in-Aid for Scientific Research(C) are outlined below. Clinical findings on the incidence of pulsus paradoxus were summed up, and a new study on the 24-hr measurement of SaO2 levels progressed using a pulse oximeter (purchases using the grant).[1] Study on the incidence of pulsus paradoxus and its significanceOf the 145 outpatients (71 in 1992 and 74 in 1993) referred to us for suspected SAS, 66 were admitted to out hospital for more detailed examinations or its treatment. The apnea type was obstructive in 61 and central in 5. Informed consent was obtained from 40 patients with obstructive SAS after giving them full information on the objectives of out study. Intrathoracic pressure (Pes) and continuous blood pressure were measured in these 40 patients under the polysomnography.Results : 1) Of the 40 patients, 26 (13/21 in 1992 and 13/19 in 1993) showed pulsus paradoxus.2) The incidence of pulsus paradoxus was higher during non-REM sl … More eep and coincided with marked decreases in Pes during obstructed inspiration. 3) Patients with pulsus paradoxus were significantly younger than those without it and showed significant decreases in Pes. 4) Appropriate treatment with nasal CPAP promptly normalized Pes by improving respiration patterns and resolved pulsus paradoxus. In conclusion, the incidence of pulsus paradoxus was 65% in patients with obstructive SAS.Therefore, obstructive SAS is clinically significant as a sign of excessive decrease in Pes. Nasal CPAP therapy was considered to be effective in SAS patients with excessive decreases in Pes.[2] Study on 24-hr changes in SaO2 levels in patients with cardiovascular diseases.Changes in SaO2 levels were monitored 24 hr per day using a pulse oximeter purchased using the study grant. Results : 1) Decreases in SaO2 durng the night progressed with deterioration of function, suggesting that 24-hr SaO2 monitoring may be a usefcardiac function evaluation method.2) In patients with tetralogy of Fallt, 24-hr monitoring of SaO2 levels showed a paradoxical variation, in which they are higher at might than in the daytime. Less