体位改变对OSAHS患者过度日间嗜睡的影响及相关性分析  

Effects of sleep body posture on subjective sleepiness in patients with OSAHS

作　　者：张欣[1] 徐彧[1] 王成禹 李佩忠[1] ZHANG Xin;XU Yu;WANG Chengyu;LI Peizhong(Department of Otorhinolaryngology,the Affiliated Huaian No.1 People＇s Hospital of Nanjing Medical University,Huaian,223300,China)

机构地区：[1]南京医科大学附属淮安第一医院耳鼻咽喉科,江苏淮安223300

出　　处：《临床耳鼻咽喉头颈外科杂志》2018年第18期1418-1421,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:研究体位改变对OSAHS患者日间嗜睡的影响及相关性分析。方法:对90例OSAHS患者行Epworth嗜睡量表嗜睡量表评分(ESS)并按呼吸暂停低通气指数(AHI)分为轻度OSAHS组(5≤AHI<15)、中度OSAHS组(15≤AHI<30)和重度OSAHS组(AHI≥30),比较体位改变对不同程度OSAHS患者日间嗜睡的影响。结果:由仰卧位变换为侧卧位时,3组微觉醒指数差异、夜间最低血氧饱和度(MinSpO2)、REM睡眠占总睡眠时间的百分率(REM%)及NREM睡眠占总睡眠时间的百分率(NREM%)均差异有统计学意义(F=12.10、43.67、15.81、13.17,均P<0.05);与仰卧位相比,OSAHS重度组侧卧位时MinSpO2、REM%及NREM%差异有统计学意义(t=3.02、2.41、2.90,均P<0.05)。仰卧位呼吸暂停指数(S-AHI)、侧卧位呼吸暂停指数(LAHI)与OSAHS轻、中度组ESS评分无相关性(P>0.05),而L-AHI与OSAHS重度组ESS评分显著相关(r=0.454,P<0.01);REM L-AHI和NREM L-AHI与OSAHS重度组ESS评分显著相关(r=0.522,P<0.01;r=0.425,P<0.001)。结论:睡眠体位改变对重度OSAHS组的睡眠结构、呼吸事件有显著的影响,与S-AHI相比,L-AHI更能反映重度OSAHS患者日间嗜睡严重程度。Objective：To observe the effects of sleep body posture on subjective sleepiness in patients with OSAHS.Method：We assessed the sleeping body position,the sleep structure,position specific AHI and the Epworth Sleepiness Scale（ESS）in a total of 90 patients with OSAHS.The patients were grouped according to AHI：mild OSAHS（5≤AHI15）,moderate（15≤AHI30）and severe（AHI≥30）.The polysomnography data and clinical characteristics were compared between each group.Result：There was statistically significant difference in arousal index,MinSpO2,REM% and NREM% among three groups（Fvalue was 12.10,43.67,15.81,13.17,respectively,P〈0.05）.Compared with supine,the severe OSAHS group had significantly bigger changes in MinSpO2,REM% and NREM%（t value was 3.02,2.41,2.90,respectively,P〈0.05）.For mild-to-moderate groups,there was no correlation between the ESS and the AHI at any position（P〉0.05）.For severe group,the ESS was significantly correlated with L-AHI（r=0.454,P〈0.01）;the REM L-AHI and NREM L-AHI was also significantly correlated with ESS of severe group（r=0.522 and 0.425,P〈0.01）.Conclusion：The sleep body posture had significant effects on sleep structure and respiratory events in severe OSAHS group.The L-AHI was found to have a closer association with daytime sleepiness in severe OSAHS than other groups.

关 键 词：睡眠呼吸暂停低通气综合征 阻塞性 睡眠体位 多次睡眠潜伏期试验 体位呼吸暂停指数 

分 类 号：R563.8[医药卫生—呼吸系统]