阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构的研究  

Research about sleep struction of OSAHS

作　　者：张宝林[1] 李秀琴[2] 王廷础[3] 

机构地区：[1]空军总医院耳鼻咽喉科,北京100036 [2]北京市海淀区甘家口医院内科 [3]山东大学卫生部耳鼻咽喉科学重点实验室

出　　处：《临床耳鼻咽喉科杂志》2005年第6期262-264,共3页Journal of Clinical Otorhinolaryngology

摘　　要：目的:研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)及单纯鼾症的睡眠结构,探讨患者白天嗜睡等症状的原因。方法:对46例OSAHS患者(OSAHS组)、16例单纯鼾症(鼾症组)及20例正常人(对照组)进行睡眠监测,对非快速眼动(NREM)、快速眼动(REM)睡眠各期所占比例计算其百分比,并统计呼吸紊乱指数(RDI)、呼吸暂停指数(AI)、低通气指数(HI),观察OSAHS患者和单纯鼾症患者在睡眠时总的微觉醒指数(MI,次/h)、伴呼吸紊乱的MI、伴腿动的MI、伴鼾声的MI、自发性MI的差别。结果:OSAHS患者有明显的睡眠结构紊乱,其浅睡眠明显增多,深睡眠明显减少,睡眠结构不全,有明显的REM睡眠剥夺现象,醒觉时间明显延长,OSAHS患者在其仅有的浅睡眠中伴有明显多的微觉醒,并且这种微觉醒伴有明显多的腿动和(或)呼吸紊乱,OSAHS患者的自发性微觉醒也明显增多。结论:OSAHS患者睡眠时的睡眠剥夺,特别是REM期睡眠剥夺、频繁唤醒、睡眠结构紊乱及呼吸紊乱引起的减血氧而导致的脑代谢紊乱,是其白天嗜睡、乏力、记忆力减退的直接原因。Objective:Research the sleep structure of the OSAHS and snores, explore the reason that patients feel drowsy in daytime.Method:Monitor the sleep of 46 OSAHS、16 snores and 20 normal control , calculate the percent of stages of NREM and REM,count the RDI、AI、HI、total MI、MI associated with leg movement、MI associated with RDI、MI associated with snore、spontaneous MI.Result:OSAHS has sleep structure disturbance obviously.The light sleep (stage Ⅰ) increase obviously,but deep one decrease (stage Ⅲ+Ⅴ)obviously. The sleep structure is insufficient. The patients are deprived of a number of the REM sleep.The waking time is longer than normal control group.During the light sleep, the microarousal that is associated with both apnea and leg movement increase obviously.Conclusion:During the sleep,OSAHS has obvious sleep deprivation,frequent arousal,disturbance sleep structure and blood desaturation,etc. These resulted in disturbances of brain metabolize.This is the reason that patients feel drowsy,feeble decline,etc.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 多道睡眠描记术 

分 类 号：R563.8[医药卫生—呼吸系统]