OSAHS患者呼吸事件持续时间与微觉醒、血氧下降时间的关系  

Relationship between sleep apnea-hypopnea duration and arousal and SaO_2 decrease duration in patients with obstructive sleep apnea-hypopnea syndrome

作　　者：孙琳[1] 黄少雄[1] 颜佳[1] 禹恩佳 罗语溪[1,3] 

机构地区：[1]中山大学工学院,广州510006 [2]中山大学附属第六医院 [3]广东省传感技术与医疗仪器重点实验室

出　　处：《山东医药》2017年第6期17-19,共3页Shandong Medical Journal

基　　金：国家自然科学基金资助项目(81570904);广东省自然科学基金资助项目(2014A030313215);广州市科技惠民项目(2014Y2-00162)

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠过程中呼吸事件持续时间的变化与微觉醒、血氧下降时间的关系。方法对12例中重度OSAHS患者行夜间多导睡眠图监测,判读睡眠呼吸事件(包括睡眠呼吸暂停、低通气)和微觉醒的发生情况。将呼吸事件分为伴随微觉醒的呼吸事件(RAR)和不伴随微觉醒的呼吸事件(N-RAR)两类,在个体内、RAR与N-RAR组间比较二者呼吸事件持续时间的差异;观察呼吸事件发生时,呼吸事件持续时间与相对应的血氧下降持续时间的关系。结果个体内比较,12例中有11例呼吸事件持续时间RAR>N-RAR,7例存在统计学差异(P<0.05或<0.01);将12例个体内归一化后分为RAR组与N-RAR组,两组呼吸事件持续时间RAR组>N-RAR组(P<0.01)。12例患者NREM期的呼吸事件持续时间为(25.6±9.4)s,血氧下降时间为(30.0±10.2)s,血氧下降时间高于呼吸事件持续时间(P<0.01)。相关性分析显示,RAR组与NRAR组的血氧下降时间与呼吸事件持续时间均呈正相关(RAR组R=0.54,N-RAR组R=0.68,P均<0.01)。血氧下降时间在N-RAR下随呼吸事件持续时间增长的速度大于RAR(N-RAR斜率为0.80,RAR斜率为0.55)。结论OSAHS患者呼吸事件持续时间的变化与微觉醒有关,持续时间越长,发生微觉醒的可能性越大;呼吸事件持续时间与血氧下降时间呈正相关,且血氧下降时间在N-RAR下随呼吸事件持续时间增长的速度大于RAR。Objective To explore the relationship among sleep apnea-hypopnea duration,arousal and SaO2 decrease duration in patients with obstructive sleep apnea-hypopnea syndrome（OSAHS）.Methods Twelve patients with moderate to severe OSAHS underwent nocturnal polysomnography,and the occurrence of sleep-related respiratory events（including sleep apnea,hypopnea） and micro-arousals were analyzed.The sleep disorder events were divided into two categories according to the respiratory events termination with or without arousals（RAR and N-RAR） and the difference in duration of respiratory events was compared within individuals and between individuals with RAR or N-RAR.When the respiratory events occurred,sleep apnea-hypopnea duration and SaO2 decrease duration were compared.Results Within individuals the respiratory event durations from 11 of 12 patients were longer in RAR than in N-RAR,and significant difference was found in 7 cases（P〈0.05 or P〈0.01）.Therein,12 patients were divided into the RAR group and N-RAR group,and the duration of respiratory events：RAR group〉N-RAR group（P〈0.01）.The duration of respiratory events in NREM was（25.6±9.4） s in 12 patients,and the SaO2 decrease duration was（30.0±10.2） s,which was longer than the duration of respiratory events（P〈0.01）.SaO2 decrease duration was positively correlated with the duration of respiratory events in the RAR and N-RAR groups（RAR：R=0.54;N-RAR：R=0.68,all P〈0.01）.The rate of the SaO2 decrease duration in the N-RAR group was greater than that of RAR group as the respiratory event duration increased（RAR：R=0.55;N-RAR：R=0.80）.Conclusions Apnea-hypopnea duration was associated with the presence of arousal,and there was a positive correlation between duration of respiratory event and SaO2 decrease duration.SaO2 decrease duration increased at a greater rate in N-RAR than in RAR with the increasing duration of respiratory events.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 睡眠呼吸事件 微觉醒 呼吸事件持续时间 血氧下降时间 

分 类 号：R563[医药卫生—呼吸系统]