REM型阻塞性睡眠呼吸暂停低通气综合征患者的性别差异  

Gender differences of REM related obstructive sleep apnea-hypopnea syndrome

作　　者：谢敏[1] 任蓉[1] 和嘉明 薛晓芳 李桃美 谭璐[1] 雷飞[1] 唐向东[1] 杨玲慧[2] 

机构地区：[1]四川大学华西医院睡眠医学中心,成都610041 [2]四川大学华西医院麻醉与危重急救研究室转化神经科学中心,成都610041

出　　处：《中华医学杂志》2017年第48期3763-3767,共5页National Medical Journal of China

基　　金：国家自然科学基金（81530002）;国家重点基础研究发展计划（2015CB856406）;国家科技支撑计划（2015BA113B01）

摘　　要：目的探讨快速眼动（REM）型阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的性别差异。方法回顾性分析2016年1至11月在四川大学华西医院睡眠医学中心以打鼾为主诉就诊的连续病例，患者均行整夜多导睡眠监测（PSG）并采集了Epworth嗜睡量表（ESS）评分。根据PSG结果，将诊断为OSAHS的患者分为REM组与非快速眼动（NREM）组，比较两组患者人口学及多导睡眠图特征的性别差异。通过多元线性回归分析呼吸暂停低通气指数（AHI）与体质指数（BMI）、颈围和腰围的关系。结果纳入的1258例OSAHS患者中男997例（79．3％），女261例（20．7％）；年龄（46．4±12．0）岁，BMI（26．6±3．4）ks／m^2。REM组236例（18．8％），NREM组1022例（81．2％），女性患者中REM型所占比例显著高于男性（34．1％比14．7％，P〈0．001）。在排除包括年龄、饮酒、吸烟、安眠药、咖啡浓茶及睡眠相关指标影响后，NREM组男性及女性患者AHI与BMI、颈围及腰围均呈正相关（均P〈0．001）；REM组女性患者AHI与BMI、颈围及腰围均呈正相关（均P〈0．05），而男性患者AHI仅与BMI及腰围相关（P〈0．05）。结论REM型OSAHS患者常见于女性。根据人体测量学指标评估REM型OSAHS患者严重度时需考虑性别因素。Objective To explore the gender differences of rapid-eye-movement （REM） related obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods Consecutive patients with primary complaint of snoring from Sleep Medicine Center of West China Hospital between January 2016 and November 2016 were included in the study. All participants underwent one night polysomnography （PSG） and Epworth sleep scale （ESS） was estimated. The patients diagnosed with OSAHS were classified as REM related OSAHS （REM-OSAHS group ） and non-rapid-eye-movement （NREM） related OSAHS （NREM- OSAHS group ） based on the PSG parameters. And the gender differences of demographic and polysomnograpic characteristics in both groups were compared. The associations between apnea-hypopnea index （AHI） and body mass index （BMI） , neck circumference and waist circumference among patients with OSAHS were explored by multiple linear regression analysis. Results A total of 1 258 patients were diagnosed with OSAHS. There were 997 （79. 3% ） male and 261 （20. 7% ） female among these patients, the mean age was （46.4 ± 12. 0） years old and mean BMI was （26. 6 ± 3.4） kg/m^2. There were 236 patients （18.8%） classified into REM-OSAHS group, and 1 022 patients （81.2%） classified into NREM-OSAHS group; the proportion of REM-OSAHS in female was significantly higher than that in male （34. 1% vs 14.7%, P 〈0. 001 ）. After controlling for age, drinking, smoking, hypnotics, coffee, strong tea and sleep related parameters, in NREM-OSAHS group, AHI was positively correlated with BMI, neck circumference and waist circumference （ P 〈 0. 001 ） both in male and female. In REM-OSAYIS group, AHI was positively correlated with BMI, neck circumference and waist circumference in female （ P 〈 0. 05 ）, but only significantly correlated with BMI and waist circumference in male （ P 〈 0.05 ）. Conclusions REMOSAHS is commonly seen in female OSAHS patients. Evaluation of the influences of anthropometric data on the

关 键 词：睡眠呼吸暂停 阻塞性 快速眼运动睡眠 性别特征 人体测量学 

分 类 号：R766[医药卫生—耳鼻咽喉科]