閉塞性睡眠時無呼吸症候群を合併した末端肥大症の1例

A Case of Obstructive Sleep Apnea Syndrome with Acromegaly

　はじめに

　睡眠時無呼吸症候群（sleep apnea syndrome：以下SAS）は，無呼吸の頻度や持続時間が増大すると肺高血圧，右心不全，高血圧，不整脈などの循環障害を引き起こし，患者の生命予後に大きな影響をもたらすことが知られている。末端肥大症にSASが高率に合併することは知られている^1〜3）が，本邦での報告例は少ない^4,5）。

　今回，換気障害から肺性心を生じ，気管切開術で救命できた閉塞性睡眠時無呼吸症候群（obstructive sleep apnea syndrome：以下OSAS）を合併した末端肥大症の1例を経験したので報告する。

A 50-year-old man with acromegaly complained of heavy snoring and sleep apnea. The diagnosis of obstructive sleep apnea syndrome was established by polysomnography. This patient also presented with marked systemic edema, dyspnea and cyanosis. Massive pleural effusion and right ventricular failure was observed. Tracheostomy was performed for relief of airway obstruction. About 2 months later, uvulo-palato-pharyngoplasty and the trans-sphenoidal surgery for pituitary adenoma were car-ried out with satisfactory effect. About 10 months later, the sleep apnea was completely improved, and the tracheostoma was closed without any trouble.