男性睡眠呼吸暂停低通气综合征患者性激素水平的改变及影响因素分析  

Variation of sex hormone profile in male patients with obstructive sleep apnea hypopnea syndrome

作　　者：曾正艳 刘亚首 武海博[1] 孔繁一[1] 刘诗翔[1] 

机构地区：[1]成都军区昆明总医院神经内科,650100 [2]昆明医科大学成都军区昆明总医院临床学院

出　　处：《疑难病杂志》2015年第10期1023-1026,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探究男性睡眠呼吸暂停低通气综合征(OSAHS)患者性激素水平的改变,并分析影响性激素水平的关键因素。方法收集2014年3月一2015年3月就诊的男性OSAHS患者85例(OSAHS组)的一般资料及临床资料。所有患者均行多导睡眠监测,记录快速动眼睡眠(REM)在整个睡眠时间中所占比(REM%)、呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(LSaO_2)及平均动脉血氧饱和度(MSaO_2)及Epworth嗜睡量表评分(ESS),同时搜集20例年龄匹配的健康男性体检者作为健康对照组。比较2组性激素水平的差异,并运用多元线性回归模型分析年龄、BMI、REM%、AHI、LSaO_2、MSaO_2及ESS与性激素之间的相关性。结果 OSAHS组BMI明显高于健康对照组(P<0.01),TT与E_2均明显低于健康对照组(P<0.01),消除BMI可能对激素水平的影响后,OSAHS组TT仍明显高于健康对照组(P<0.01),而E_2在2组之间的差异不复存在(P>0.05)。多元线性回归分析发现,患者年龄与E_2呈显著负相关(β=-0.37,P<0.01);MSaO_2与TT(β=0.31,P=0.02)及E_2(β=0.93,P<0.01)均呈显著正相关,其他指标与TT及E_2之间无明显相关性。结论 OSAHS男性患者TT及E_2水平明显低于正常人群,E_2的降低可能与肥胖有关,而TT的降低可能是OSAHS本身,或者OSAHS与肥胖的协同作用导致的。E_2水平随着年龄的增长而降低;E_2与TT浓度也均随着缺氧程度的加重而降低。Objective To explore the changes of sex hormone levels in male patients with obstructive sleep apnea hy -popnea syndrome （ OSAHS） and to analyze the key factors of affecting sex hormone levels .Methods General information and clinical data of 85 male OSAHS patients （ OSAHS group ） who were treated from March 2014 to March 2015 were collected . All patients underwent multichannel monitoring of sleep , and rapid eye movement （ REM） sleep in total sleep time ’ s ratio （REM%）, apnea saturation （MSaO2） and average artery of hypopnea index （AHI）, minimum arterial oxygen saturation （LSaO2） of the oxygen and Epworth Sleepiness Scale （ESS） were recorded, we collected 20 cases of age matched healthy male subjects as healthy control group .Differences of sex hormone levels were compared between the two groups , and the use of multiple linear regression model to analyze the correlation between age , BMI, REM%, AHI, LSaO2 , MSaO2 and ESS and sex hormone.Results BMI of OSAHS group was significantly higher than those in healthy control group （ P 〈0.01）, TT and E2 were significantly lower than healthy control group （ P 〈0.01）, eliminated BMI potential effect on the hormone lev-els, TT in OSAHS group was still significantly higher than those in healthy control group （ P 〈0.01）, and E2 differences be-tween the 2 groups were disappeared （ P 〉0.05）.Multiple linear regression analysis showed that , age of patients and E2 showed significant negative correlation （β=-0.37, P 〈0.01）;MSaO2 and TT （β=0.31, P =0.02） and E2 （β=0.93, P 〈0.01） showed a significant positive correlation , and other indicators of TT and E2 had no clear relationship.Conclusion OSAHS male patients’ TT and E2 levels were significantly lower than the normal population , E2’s reduction may be associated ;nbsp;with obesity, and TT’s reduce maybe due to OSAHS itself, or OSAHS and synergistic effect of obesity .E2 levels’ decreased along with age increasing;E2 and TT levels were decrease

关 键 词：睡眠呼吸暂停低通气综合征 男性 性激素 多导睡眠监测 

分 类 号：R766[医药卫生—耳鼻咽喉科]