阻塞性睡眠呼吸暂停低通气综合征对飞行员情绪状况的影响  

Alteration in mood of pilots with obstructive sleep apnea/hypopnea syndrome

作　　者：崔丽[1] 徐先荣[1] 王铃[1] 刘福麟[2] 崔彩娟[1] 刘玉华[1] 王露今[1] 付兆君[1] 郑军[1] 

机构地区：[1]空军总医院全军临床航空医学中心,北京100142 [2]解放军第261医院精神病四科

出　　处：《解放军医学杂志》2009年第10期1247-1249,共3页Medical Journal of Chinese People's Liberation Army

基　　金：全军医药卫生"十一五"科研项目资助课题(06Z010)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对飞行员情绪状况的影响。方法对57名临床有睡眠异常主诉的飞行员进行多导睡眠图(PSG)监测,依据中华医学会呼吸病学分会睡眠呼吸疾病组制定的《阻塞性睡眠呼吸暂停低通气综合征诊治指南(草案)》进行临床诊断,其中鼾症组(PS)17人,OSAHS组40人。另选取同期健康体检飞行员20人作为对照组。所有入选者进行Epworth嗜睡程度问卷(ESS)、Zung抑郁自评量表(SDS)及焦虑自评量表(SAS)的自评。比较鼾症组、OSAHS组患者与对照组入选者情绪状况的差异,比较鼾症组及OSAHS组抑郁或焦虑的发生率,分析鼾症组、OSAHS组患者的SAS、SDS评分与ESS评分、PSG检测结果间的相关性。结果鼾症组及OSAHS组SDS、SAS标准分平均值明显高于对照组(P<0.01)。OSAHS组抑郁发生率较鼾症组增高(χ2=5.522,P<0.05);而两组间焦虑发生率无统计学差异(χ2=1.601,P>0.05)。OSAHS组SDS、SAS标准分与ESS评分间存在显著正相关(r=0.58,P<0.01;r=0.41,P<0.01),但与PSG各项参数间未见明显相关性。结论飞行员患OSAHS存在不同程度的焦虑或抑郁情绪,在临床医学鉴定及治疗中应注意情绪状况对飞行能力的影响。Objective To explore mood alteration in pilots with obstructive sleep apnea/hypopnea syndrome（OSAHS）.Methods According to the Diagnosis and Treatment of OSAHS Manual（protocol） drafted by Sleep Apnea Disease Group of Chinese Society of Respiratory Disease of Chinese Medical Association,57 pilots complained of sleep disorders were diagnosed as OSAHS（n=40） and primary snoring（PS,n=17） using polysomnography（PSG）.Twenty healthy subjects hospitalized for annual check-up were selected as control group.The findings of all subjects were evaluated using Epworth Sleepiness Scale（ESS）,Self-Rating Depression Scale（SDS） and Self-Rating Anxiety Scale（SAS）.The standard scores of SDS and SAS were compared among primary snoring group,OSAHS group and control group.The ratios of patients with depression or anxiety symptoms in primary snoring group and OSAHS group were also compared.The correlation of SDS score and SAS score in different groups with ESS score and PSG parameters were assessed.Results Compared with the healthy control subjects,patients in primary snoring group and OSAHS group had obvious symptoms of depression and anxiety（P〈0.01）.There were more patients with depression in OSAHS group than in primary snoring group（χ2=5.522,P〈0.05）,while the ratio of patients with anxiety symptoms showed no significant difference between the two groups（χ2=1.601,P〉0.05）.In OSAHS group,positive correlation existed between ESS and SDS scores and between ESS and SAS scores（r=0.58 and r=0.41,P〈0.01）,but no significant correlation existed between PSG results（including AHI and MinSaO2） and the scores of SDS or SAS.Conclusions Pilots suffering from OSAHS usually have depression or anxiety symptoms,which may influence the cognition and performance in flying.So more attention should be paid to mood alteration in pilots diagnosed to have OSAHS when considering medical assessment and treatment.

关 键 词：睡眠呼吸暂停 阻塞性 情绪障碍 飞行员 

分 类 号：R338.63[医药卫生—人体生理学] R749.4[医药卫生—基础医学]