老年人夜间睡眠呼吸障碍的临床探讨及其诊断分型研究  

CLINICAL SURVEY OF SLEEP APNEA IN THE ELDERS: DIAGNOSIS AND CLASSIFICATION

作　　者：贺凤凤[1] 房美娟[1] 周琦[1] 朱惠如[2] 张瑞芳[2] 余霞珍[2] 

机构地区：[1]上海医科大学附属华山医院老年病科,200040 [2]上海医科大学附属华山医院呼吸科,200040

出　　处：《老年医学与保健》1999年第4期166-168,共3页Geriatrics & Health Care

摘　　要：目的 探讨老年入夜间睡眠呼吸障碍患病率、类型、严重程度以及与心脑血管病、慢支的相关性。方法对120例住院患者进行一夜睡眠时脉搏血氧饱和度(SaO_2)监测，同时对其中30例夜间睡眠呼吸暂停综合征(SAS)的患者再进行多导程生理仪监测，并结合临床病史、睡眠打鼾、肥胖、白天嗜睡、夜间憋醒等确定诊断和分型。结果120例患者经血扭送饱和度监测初步诊断SAS患者65例，检出阳性率为54%。其中30例SAS患者再经多导程生理仪监测结果，轻度21例，中度7例，重度2例。分型阻塞性SAS15例，混合性SAS15例。结论 本组SAS患病率为54%，而且是老年人心及血管病及慢支的常见合并症，相到影响造成严重反复发作睡眠时低扭送血决一雌雄、高碳酸血症，导致各系统脏器病理生理改变，可诱发老年慢性病的急变，临床出现高血压、心较痛、心律失常、心衰竭，甚至发生猝死，严重危害老年人的健康甚至生命安全。老年夜间出现呼吸障碍的严重程度在白昼及桓时难以预测，一定要通过SaO_2监测仪或多导程生理仪睡眠时监测结合监床才能确诊，后者更为精确，可为SAS诊治提供重要依据，为此SAS应引起临床高度重视，尤其是对患有心及血管病、慢支、肥胖、打鼾的老年人应做睡眠监测以便诊治，防止老年人慢性病加重甚至急性发作。ve Surveying the classification and severity of sleep apnea syndrome (SAS) in the el-ders with vascular diseases and chronic bronchitis. Methods 120 inpatients were taken Sa02 in sleeping with oximetry . 30 of those with SAS were carried out polysomnography. SAS was classified, according to clinical history, snoring and suffocating at nights, fatty and sleepy at daytime. Results 65 of 120 inpatients were primarily di-agnosedas SAS. The positive rate was 54% . Among 30 of SAS taken polysomnography, 21 were light SAS, 7 mod-erate SAS, and 2 severe. In classification, 15 of those 30 suffered with obstructive SAS, 15 with mixed SAS. Conclusions The incidence of SAS is 54% . SAS can aggravate anoxemia, produce pathophysiologic changes of systems, and induce acute onset of chronic diseases. It is usually accompanied with vascular diseases and chronic bronchitis. In clinic, the patients with SAS may suffer with hypertension, angina pectoris, arrhythmia, heart fail-ure, and even sudden death. The onset and the severity of SAS are difficult to diagnose at daytime or at sober time. Only with the help of oximetry and polysomnography can SAS be sure. Polysomnography is more useful and can pro-vide more data than oximetry. Practitioners should pay more attention to SAS, especially in the patients with vascu-lar diseases, chronic bronchitis, fatty and snoring elders. The more early diagnosis and treatment the better.

关 键 词：老年人 SAS 夜间睡眠 呼吸障碍 诊断 心脑血管病 患者 结论 混合性 生理 

分 类 号：R766.43[医药卫生—耳鼻咽喉科] R541[医药卫生—临床医学]