背景與目的：阻塞性睡眠呼吸中止症(obstructive sleep apnea OSA)之病徵為週期性重覆發生的上呼吸道阻塞。患者常合併全身性及呼吸道局部發炎之現象，但其與肺功能之間的關係尚不清楚。本研究目的為藉由誘發痰液之方式評估重度OSA患者之呼吸道發炎程度，並探討發炎及疾病嚴重度對肺功能的影響。方法：本研究招募20位平均年齡為50.35±8.95歲、具重度OSA診斷之自願受試者。以肺量計測試評估其肺功能；另以誘發痰液檢體分析其呼吸道發炎程度。統計以皮爾森相關係數(Pearson correlation coefficient)評估參數問之相關性。結果：受試者平均用力吐氣肺容量(FVC)與平均第一秒用力吐氣量(FEV1)均在正常範圍內，分別為預測值之102.72±11.10%及97.78±12.30%；兩者之比值(FEV1/FVC)則為77.20±3.43%；平均用力吐氣中段流速(FEF(下标 25-75))較低，為預測值之68.70±14.40%。痰液之平均細胞濃度為2.01±1.37×10^6個／毫升，嗜中性球比例為59.20±20.94%，巨噬細胞比例為30.04±20.67%。AHI指數(apnea hypopnea index, AHI)和痰液中嗜中性球比例呈顯著中度正相關(r=0.45, p<0.05)；和痰液中之巨噬細胞比例則呈現顯著中度負相關(r=-0.45, p<0.05)。但發炎指標與肺功能之間均無顯著相關。結論：本研究結果顯示重度OSA之患者其呼吸道存在發炎反應，其發炎特徵為有較高比例的嗜中性球與較低比例的巨噬細胞。患者之疾病嚴重度與呼吸道發炎程度具中度相關。患者較低之FEF(下标 25-75)、顯示長期追蹤OSA患者其小氣道功能變化有其必要性。

Background and Purpose: Obstructive sleep apnea (OSA) is characterized by episodes of repetitive upper airway obstruction during sleep. Evidence of both systemic and airway inflammation had been found in patients with OSA. However, the relationship between airway inflammation and pulmonary function remains unclear. The objective of this study were (1) to evaluate the degree of airway inflammation by induced sputum in patients with severe OSA, and (2) to investigate the correlations between airway inflammation, disease severity, and pulmonary function parameters. Methods: Twenty treatment-naïve patients with severe OSA (mean age: 50.35±8.95 y/o) were recruited. Spirometry was used to evaluate pulmonary function and airway inflammation was assessed by induced sputum. Pearson correlation coefficient was used to explore the correlations between parameters. Results: The mean FVC (102.72±11.10% of predicted) and FEy1 (97.78±12.03% of predicted) of all subjects were within normal range, and the mean FEV1/FVC ratio was 77.20±3.43%. Compared to healthy population, the FEF(subscript 25-75) was relatively low in patients with severe OSA (68.70±14.40% of predicted). The mean cell concentration in induced sputum was 2.01±1.37×10^6 cells/ml. The neutrophil and macrophage percentage in induced sputum was 59.20±20.94% and 30.04±20.67%, respectively. Significant positive correlation between AHI and neutrophil percentage was found (r=0.45, p<0.05), and AHI was negatively correlated with macrophage percentage (r=-0.45. p<0.05). No significant correlation was found between inflammatory markers and pulmonary function parameters in the study population. Conclusions: Airway inflammation existed in patients with severe OSA, which was characterized by a higher neutrophil and a lower macrophage percentage. Disease severity was found to moderately correlate with airway inflammation. Lower FEF(subscript 25-75) predicted value suggested that it is necessary to evaluate the small airway function of these patients longitudinally.