论文部分内容阅读
目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠呼吸事件与继之发生的低氧血症的关系及临床意义。方法:选取夜间打鼾并疑有睡眠呼吸障碍者45例,分为4组:正常打鼾组、轻度OSAHS组、中度OSAHS组和重度OSAHS组。填写Epworth嗜睡问卷,并进行整夜睡眠监测,记录各项睡眠参数及每次睡眠呼吸事件开始至随之出现血氧饱和度下降的时间,定义为氧减延迟时间。结果:45例患者均发生了阻塞性睡眠呼吸事件。中度OSAHS组的平均氧减延迟时间大于正常打鼾组(P<0.05)和轻度OSAHS组(P<0.05),重度OSAHS组的平均氧减延迟时间也大于正常打鼾组(P<0.01)和轻度OSAHS组(P<0.01),而正常打鼾组和轻度OSAHS组间(P>0.05)、中度OSAHS组和重度OSAHS组间(P>0.05)差异无统计学意义;平均氧减延迟时间与呼吸暂停指数(AHI)呈线性正相关(r=0.608,P<0.01)、与最低血氧饱和度(LSaO2)呈线性负相关(r=-0.543,P<0.01);平均氧减延迟时间与Epworth问卷前7项总分(ESS7)的相关性(r=0.689,P<0.01)高于AHI、LSaO2与ESS7的相关性(r=0.486,P<0.01;r=-0.422,P<0.01)。结论:氧减延迟时间是描述血氧变化对阻塞性睡眠呼吸事件敏感性的指标,本研究中、重度OSAHS患者平均氧减延迟时间较正常打鼾者和轻度OSAHS患者明显延长;平均氧减延迟时间分别与AHI、LSaO2密切相关;其与ESS7的相关性大于AHI、LSaO2与ESS7的相关性,提示平均氧减延迟时间在一定程度上能反映OSAHS患者病情严重程度,在反映患者白天嗜睡程度方面优于AHI和LSaO2。
Objective: To investigate the relationship between sleep-respiratory events and subsequent hypoxemia in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) and its clinical significance. Methods: Forty-five patients with snoring at night and suspected sleep apnea were divided into 4 groups: normal snoring group, mild OSAHS group, moderate OSAHS group and severe OSAHS group. The Epworth sleepiness questionnaire was filled in and sleep monitoring was performed overnight to record the sleep parameters and the time from the start of each sleep apnea event to the consequent decrease of oxygen saturation. Results: All 45 patients had obstructive sleep apnea events. The average oxygen reduction delay of moderate OSAHS group was longer than that of normal snoring group (P <0.05) and mild OSAHS group (P <0.05), and the average oxygen reduction delay time of severe OSAHS group was longer than that of normal snoring group (P <0.01) Mild OSAHS group (P <0.01), but no significant difference between normal OSAHS group and moderate OSAHS group (P> 0.05), moderate OSAHS group and severe OSAHS group (P> 0.05) The time was positively correlated with the apnea index (AHI) (r = 0.608, P <0.01) and linearly with the lowest oxygen saturation (LSaO2) (r = -0.543, P <0.01) (R = 0.689, P <0.01) was higher than that of AHI, LSaO2 and ESS7 in the Epworth questionnaire (r = 0.486, P <0.01; r = -0.422, P < 0.01). Conclusion: Oxygen reduction delay time is an indicator of the sensitivity of blood oxygen changes to obstructive sleep apnea events. In this study, the mean hypoxia delay time of patients with severe OSAHS was significantly longer than that of normal snorers and mild OSAHS patients. The mean hypoxia delay Time and AHI, LSaO2 are closely related; its correlation with ESS7 greater than AHI, LSaO2 and ESS7 correlation, suggesting that the average oxygen delay delay time to a certain extent, reflect the severity of OSAHS patients in reflecting the extent of daytime sleepiness in patients Better than AHI and LSaO2.