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目的探知中老年女性睡眠打鼾流行特征和阻塞性睡眠呼吸暂停低通气综合征(obstructivesleepapneahypopneasyndrome,OSAHS)的患病率、症状及相关因素。方法以问卷方式对北京市西城区丰盛街道办事处所辖区内40岁以上女性1336人进行横断面调查,其中1220人可以给出量表评分,根据评分分层抽样,对样本进行多道睡眠监测,以呼吸暂停低通气指数(apneahypopneaindex,AHI)≥5次/h且伴有白天嗜睡为诊断OSAHS标准,将样本分为病例组和健康对照组,推算调查人群患病率,比较病例组和健康对照组的症状,分析可能的相关因素对AHI的影响。结果明确承认有不同程度打鼾者占34.3%,且随着年龄、体重指数升高,每周发生5~7次打鼾者的比率也趋于增高;生育期女性占3.8%,绝经期女性13.7%。调查对象总体OSAHS患病率为11.1%;单纯AHI≥5次/h、10次/h、15次/h者分别占41.1%、24.0%、17.0%。打鼾(5~7)天/周者的AHI是没有打鼾者的5倍,打鼾声隔壁也能听到者是非打鼾者的7.5倍;但病例组中有93.8%(15/16)存在不同程度的打鼾,健康对照组中也有79..1%(34/43),差异无统计学意义(P=0.182);病例组发生睡眠呼吸困难窒息、晨起口干的比率高于对照组,差异有统计学意义(P值分别为0.002、0.034)。多元线性回归分析,AHI变量的24.4%可由体重指数(14.9%)和血清卵泡刺激素水平(9.5%)解释。结论中老年女性人群中打鼾的发生率很高,OSAHS患病率为11.1%,主要表现为睡眠呼吸困难窒息、晨起口干;打鼾与病情严重程度密切相关,但不能作为区分患者的依据;肥胖程度和性激素水平与该综合征的发病可能有关。
Objective To explore the prevalence of sleep snoring and obstructive sleep apnea-hypopnea syndrome (OSAHS) among middle-aged and elderly women. Methods A cross-sectional survey of 1,336 women over the age of 40 within the jurisdiction of the Fensheng Subdistrict Office in Xicheng District, Beijing was carried out by questionnaire. Among them, 1220 were scored by scale, stratified sampling according to the scores, The apnea hypopnea index (apnea hypopnea index, AHI) ≥ 5 times / h and daytime sleepiness were used to diagnose OSAHS. The samples were divided into case group and healthy control group, and the prevalence of the surveyed population was calculated. The case-control group and healthy control group Group of symptoms, analyze the possible impact of related factors on AHI. The results clearly admitted that there are 34.3% of snorers with different degrees, and with age, body mass index, weekly occurrence of 5 to 7 times the snorers also tend to increase the rate; during the growing women accounted for 3.8%, 13.7% . The prevalence of OSAHS in the surveyed subjects was 11.1%. AHI≥5 beats / h, 10 beats / h, and 15 beats / h accounted for 41.1%, 24.0%, 17.0%, respectively. The AHI of snoring (5-7) days / week was 5 times higher than those without snoring, and 7.5 times more likely to be heard by non-snorers next to snoring. However, 93.8% (15/16) (P = 0.182). In the case group, the rate of asphyxia in sleep dyspnea and early dry mouth was higher than that in the control group, and the difference was not statistically significant There was statistical significance (P = 0.002,0.034 respectively). In the multiple linear regression analysis, 24.4% of AHI variables were explained by a body mass index (14.9%) and serum FSH level (9.5%). Conclusion The incidence of snoring in middle-aged and elderly women is very high. The prevalence of OSAHS is 11.1%. The main manifestations are asphyxia in sleep dyspnea and dry mouth in the early morning. Snoring is closely related to the severity of illness, but can not be used as a basis for distinguishing patients. The level of obesity and sex hormone levels may be related to the incidence of the syndrome.