198例老年睡眠呼吸暂停综合征多导睡眠图分析  

Analysis of polysomnograms in 198 patients with sleep apnea/hypopnea syndrome.

作　　者：顾洁[1] 陈小东[1] 

机构地区：[1]复旦大学附属华山医院老年科、呼吸科,上海200040

出　　处：《老年医学与保健》2008年第6期364-367,共4页Geriatrics & Health Care

摘　　要：目的 分析总结198例老年睡眠呼吸暂停综合征患者（slee papnea／hypopnea syndrome，SAHS）的多导睡眠图（polysonmography，PSG）特点。方法 198例均为在华山医院睡眠诊疗中心诊断为老年SAHS患者，分析其PSG，描述其中139例不同程度阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome OSAS）患者的PSG特征；探讨 OSAS患者体重指数（body mass index，BMI）与呼吸暂停事件及夜间间断性缺氧的相关性；对OSAS患者睡眠结构紊乱与呼吸暂停事什及夜间低氧血症进行相关性分析。结果198例SAHS患者中以阻塞性为主的有139例，占70．2％，140例OSAS患者均有不同程度的夜间间断性低氧和睡眠结构紊乱。相关分析显示Ⅰ期睡眠（S1）与睡眠呼吸暂停低通气指数（AHI）、氧减饱和指数（ODI）及血氧饱和度〈90％／总睡眠时间（％SpO2〈90％）呈正相关，与平均氧饱和度（MSaO2）呈负相关；Ⅱ期睡眠（S2）与最低氧饱和度（LSaO2）及MSaO2呈正相关，与AHI、ODI及％SpO2〈90％呈负相关；Ⅲ＋Ⅳ期睡眠（S3＋4）与MSaO2呈正相关，与％SpO2〈90％呈负相关，AHI、ODI及LAT呈负相关，均有统计学意义。而患者的BMI与AHI和ODI呈正相关；与LSaO2和MSaO2呈负相关，有统计学意义；与最长暂停时间（IAT）和％SpO2〈90％无相关。结论本研究资料表明PSG是目前诊断SAHS的金标准。OSAS是最为多见的SAHS类型，而首次确诊的OSAS患者中以重度患者最多，提示SAS的早期发现率较低。体重指数可提示OSAS的严重程度，OSAS患者存在睡眠结构紊乱，并随呼吸暂停事件及夜间低氧血症的加重而加重。Objective To analyze characteristics of polysomnograms （PSG） in 198 patients with sleep apnea/ hypopnea syndrome （SAHS）. Methods PSG of 198 patients who were diagnosed with SAHS in the Sleep Diagnosis and Treatment Center of Huashan Hospital were analyzed. Results Of the 198 patients, 139 patients （70.2%） had obstructive SAS （OSAS）, who presented with different levels of intermittent hypoxia and sleep structure disorders. Pearson correlation test indicated that S, sleep was positively correlated with AHI, ODI and %SpO2〈90%, and negatively correlated with MSaO2; S2 sleep was positively correlated with LSaO2, and MSaO2, and negatively correlated with AHI, ODI and % SpO2 〈 90 %. S3＋4 was negatively correlated with MSaO2 and %SpO2 〈 90 %. REM sleep was positively correlated with ODI and %SpO2〈90%, and negatively correlated with MSaO2. Otherwise, BMI was positively correlated with AHI and ODI, and negatively correlated with LSaO2 and MSaO2, and there was no significant correlation between BMI and %SpO2〈90%. Conclusions： OSAS is the most common type of SAHS. Most OSAS cases were severe when the patients first came for diagnosis and treatment, indicating that the early detection rate of OSAS remains low. BMI could suggest the level of OSAS to a certain extent. There exists sleep structure disturbance in OSAS patients, which aggravates with the worsening of sleep apnea and nocturnal intermittent hypoxia.

关 键 词：睡眠呼吸暂停综合征 多道睡眠描记术 低氧血症 睡眠 

分 类 号：R563.8[医药卫生—呼吸系统]