肥胖症和阻塞性睡眠呼吸暂停综合征  

Obesity and Obstructive Sleep Apnea Syndrome

作　　者：石湘芸[1] 聂舟山[2] 王洪武[2] 李瑞平[2] 张宁坤[1] 张昭馥[3] 王苏苏[3] 

机构地区：[1]海军总医院心内科,北京100037 [2]海军总医院呼吸科,北京100037 [3]海军总医院干三科,北京100037

出　　处：《海军总医院学报》2005年第2期77-79,共3页Journal of Naval General Hospital of PLA

摘　　要：目的探讨肥胖对阻塞性睡眠呼吸暂停综合征的作用及其影响。方法选择超重/肥胖或(和)中心型肥胖135例患者做多导睡眠图检查。根据睡眠呼吸暂停低通气指数和经皮血氧饱和度分轻(n=46)、中(n=39)和重度(n=34)阻塞性睡眠呼吸暂停综合征组及对照组16例。结果超重/肥胖者91.7%合并阻塞性睡眠呼吸暂停综合征,正常、轻、中和重度阻塞性睡眠呼吸暂停综合征分别占8.3%、32.2%、31.4%和28.1%;中心型肥胖88.7%合并阻塞性睡眠呼吸暂停综合征,正常、轻、中和重度阻塞性睡眠呼吸暂停综合征分别占11.8%、34.1%、28.9%和25.5%,两组间各患病率比较均无统计学意义(χ2=0.187～0.201,P均>0.05)。随体重指数、腰围和颈围的增加,阻塞性睡眠呼吸暂停综合征的严重程度越高(P<0.01)。体重指数、腰围、颈围与低通气指数均呈正相关(r=0.326、0.432和0.475,P均<0.05),与入睡中血氧饱和度最低值及血氧饱和度平均值均呈负相关(r=-0.302～-0.539,P均<0.05),其相关程度依次为颈围>腰围>体重指数。结论总体脂和局部体脂增加是阻塞性睡眠呼吸暂停综合征的主要危险因素之一,颈围、腰围与阻塞性睡眠呼吸暂停综合征的相关性优于体重指数。Objective To imvestigate the relationship between obesity and obstructive sleep apnea syndrome (OSAS). Methods Polysomnography (PSG) was examined in 135 cases with overweight [body mass index (BMI) 24 to 27.9 kg/m^2], obesity (BMI≥28 kg/m^2) or central obesity [waist circumference (WC)>80 cm (woman) or >85 cm (man)]. Results 91.7% of the cases with Overweight-obesity had OSAS, 88.7% of central obesity had OSAS (P>0.05). The ratios of patients with normal、mild、modreate and severe OSAS in the two groups were 8.3% and 11.8%、32.2% and 34.1%、31.4% and 28.9%、28.1% and 25.5% respectively (χ~2 0.187 to 0.201, all P>0.05). The prevalance of OSAS was increased with BMI、WC and neck circunmference (NC) (all P<0.01). Apnea hyponea index (AHI) was significantly positively correlated to BMI (r=0.326, P<0.05), WC(r=0.432, P<0.01), and NC(r=0.475, P<0.01). BMI、WC and NC (r -0.302 to -0.539,P<0.05) was significantly negatively correlated to the minimum value of transcutancous saturation oxygen (SpO2) and the mean value of SpO2 during sleep .Conclusion The total and regional body fat is an important risk factor for OSAS. OSAS is more correlated with WC and NC than BMI.

关 键 词：肥胖症 睡眠呼吸暂停综合征 多导睡眠图 

分 类 号：R589.2[医药卫生—内分泌] R563.8[医药卫生—内科学]