肥胖肺换气低下综合征二例太原市建筑工程总公司职工医院（０３０００１）程宝珍，白晋珍，高俊秋，方敏例１男，３５岁。主因肥胖８年，睡眠时呈周期性呼吸２年，气短、双下肢水肿２月入院。查体：体温３７℃，脉搏１１４次／分，呼吸２６次／分，血压２１／１２ｋＰａ，体重９５ｋｇ，身高１．５７米。高枕卧位，唇舌紫绀，颈静脉怒张，双肺底可闻小水泡音，心律齐，心率１１４次／分，肺动脉瓣区第二音亢进并分裂，腹部膨隆，肝右肋下１．５ｃｍ，质软有压痛，双下肢水肿。辅助检查：白细胞１０．５×１０９／Ｌ中性８２％，血红蛋白１６０ｇ／Ｌ红细胞５．５×１０１２／Ｌ，肝功能、血浆蛋白、尿素氮、尿１７羟类固醇、尿１７酮类固醇均正常，抗核抗体试验阴性，二氧化碳结合力２６ｍｍｏｌ／Ｌ，动脉血氧分压８．２ｋＰａ，二氧化碳分压５．４２ｋｐａ。肺功能：混合性通气障碍。超声心动图：各房室大小正常，左室顺应性差。心电图示窦性心动过速，　　　　　　　　　　　　　肺型Ｐ波，顺钟向转位。胸片心脏呈横位，肺动脉段稍突，右肺下动脉增宽达１７ｍｍ，隔肌抬高。例２女，６６岁。主因肥胖２２年，睡眠时呈周期性呼吸５年，气短、双下肢水肿３月加重１周入院。查体：体温３７．１℃，脉搏 Two cases of obesity lung hypogonadal syndrome Taiyuan City Construction Engineering Corporation Staff Hospital (030001) Cheng Baozhen, Bai Jinzhen, Gao Junqiu, Fang Min example 1 male, 35 years old. Mainly due to obesity for 8 years, during sleep was periodic breathing 2 years, shortness of breath, double edema February admission. Physical examination: body temperature 37 ℃, pulse 114 beats / min, breathing 26 beats / min, blood pressure 21 / 12kPa, weight 95kg, height 1.57 meters. High pillow position, cyanosis of the tongue, jugular vein engorgement, both lungs can be heard a small blisters sound, heart rate Qi, heart rate 114 beats / min, pulmonary valve area second tone hyperthyroidism and split, bulging abdomen, liver right rib 1.5cm , Soft tenderness, lower extremity edema. Auxiliary examination: white blood cells 10.5 × 109 / L neutral 82%, hemoglobin 160g / L red blood cells 5.5 × 1012 / L, liver function, plasma protein, urea nitrogen, urinary 17 hydroxysteroid, urinary 17 ketosteroids were normal, Antinuclear antibody test negative, carbon dioxide binding 26mmol / L, arterial oxygen partial pressure 8.2kPa, carbon dioxide partial pressure 5.42kpa. Pulmonary function: mixed ventilation disorders. Echocardiography: The size of each atrioventricular compartment, poor left ventricular compliance. Electrocardiogram shows sinus tachycardia, pulmonary P wave, cis-clockwise translocation. Chest X-ray was transverse, pulmonary artery segment slightly protruding, right lower pulmonary artery width up to 17mm, diaphragm elevation. Example 2 female, 66 years old. The main cause of obesity for 22 years, during sleep was periodic respiratory 5 years, shortness of breath, lower extremity edema in March aggravate 1 week admission. Physical examination: body temperature 37.1 ℃, pulse