Inspiratory flow-volume curve in snoring patients with and without obstructive sleep apnea

We analyzed the flow-volume curves of 50 patients with complaints of snoring and daytime sleepiness in treatment at the Pneumology Unit of the University Hospital of Brasília. The total group was divided into snorers without obstructive sleep apnea (OSA) (N = 19) and snorers with OSA (N = 31); the patients with OSA were subdivided into two groups according to the apnea/hypopnea index (AHI): AHI<20/h (N = 14) and AHI>20/h (N = 17). The control group (N = 10) consisted of nonsmoking subjects without complaints of snoring, daytime sleepiness or pulmonary diseases. The population studied (control and patients) consisted of males of similar age, height and body mass index (BMI); spirometric data were also similar in the four groups. There was no significative difference in the ratio of forced expiratory and inspiratory flows (FEF50 per cent/FIF50 per cent) in any group: control, 0.89; snorers, 1.11; snorers with OSA (AHI<20/h), 1.42, and snorers with OSA (AHI>20/h), 1.64. The FIF at 50 per cent of vital capacity (FIF50 per cent) of snoring patients with or without OSA was lower than the FIF50 per cent of the control group (P<0.05): snorers 4.30 l/s; snorers with OSA (AHI>20/h) 3.69 l/s; snorers with OSA (AHI>20/h) 3.17 l/s and control group 5.48 l/s. The FIF50 per cent of patients with severe OSA (AHI>20/h) was lower than the FIF50 per cent of snorers without OSA (P<0.05): 3.17 l/s and 4.30 l/s, respectively. We conclude that 1) the FEF50 per cent/FIF50 per cent ratio is not useful for predicting OSA, and 2) FIF50 per cent is decreased in snoring patients with and without OSA, suggesting that these patients have increased upper airway resistance (UAR).

Avaliaçäo da resposta ao broncodilatador em DPOC e asma / Bronchodilator response in asthma and obstructive bronchopulmonary disease

O presente trabalho constitui análise retrospectiva de 106 espirogramas, que estudou o comportamento de dois grupos de 53 pacientes cada, a saber, DPOC e asma brônquica (AB) diante do uso de broncodilatador (BCD) (fenotenol, 2 bombadas = 200 microgramas). Os resultados obtidos mostraram resposta significativa entre asmáticos (t < 0.05) em comparaçäo com a resposta discreta, mas existente, em pacientes com DPOC. O trabalho aponta como indicadores mais confiáveis para estimar a resposta ao broncodilatador, índice de Tifneau (p=0.43-DPOC e p=0.01-asma), o FEF 25/75 por cento p=0.78-DPOC e p=0.01-asma) e o VEF1 (p=0.37-DPOC e p=0.006-asma), sendo este o mais sensível entre os valores aferidos. Os resultados säo compatíveis com a literatura. Dos 53 casos de asma, 48 säo de ambulatório, 4 da enfermaria e um do Pronto Socorro. Quanto à distribuiçäo por sexo, observou-se prevalência, no DPOC, do sexo masculino da ordem de 41 em 53 casos, enquanto no grupo asma observou-se a prevalência feminina da ordem de 32 em 53 casos (Figura 1). O trabalho é útil para distinçäo simples entre DPOC e ASMA e confirma a expectativa de que a broncorresponsividade constitui atributo singular da asma, prevalente ao nível de grandes vias e com percentual médio de diferença (pré e pós uso de B.C.D.) em torno de 11 por cento