肺血管外水分量の増加を認めた睡眠時無呼吸症候群の1例

A Case of Obstructive Sleep Apnea Syndrome with Increased Lung Water during Sleep

　症例は22歳，男性．顎関節硬直症，小顎症の診断にて当院形成外科入院中であったが，いびき，昼間の傾眠傾向を認め，当科受診．睡眠時レスピグラフにて閉塞型を中心とした無呼吸を認め，閉塞型睡眠時無呼吸症候群と診断した．睡眠時に肺循環動態モニタリングおよび肺血管外水分量測定を施行し，無呼吸時に低酸素血症，肺動脈圧上昇，肺血管外水分量，中心血液量の増加を認めた．無呼吸時の肺血管外水分量の増加は低酸素血症による肺動脈圧の上昇や胸腔内圧の変化による静脈還流の増加などによるhemodynamicな要因が重要であると思われた．本症例は下顎形成術後，血液ガス分析やApnea indexの改善をみた．

A 22-year-old man was admitted to the department of plastic surgery in our university with diagnosis of ankylosis and microgeniea. His complaints were snor-ing and somnolence in the daytime, so we performed a Respigraph (Chest) that showed obstructive apnea during sleep. We diagnosed obstructive sleep apnea syndrome. So we observed pulmonary circulation and measured lung water using the double indicator dilution method (Nihon Koden, MTV-1100) during sleep.