阻塞性睡眠呼吸暂停低通气综合征与失眠共病患者的临床特点及相关因素分析  

Analysis of the clinical characteristics and relevant factors of comorbid obstructive sleep apnea hypopnea syndrome and insomnia

作　　者：刘奕姝 于悦 谭慧文 曾尹 肖莉[1,3] LIU Yishu;YU Yue;TAN Huiwen;ZENG Yin;XIAO Li(Department of Respiratory Medicine,Shengjing Hospital,China Medical University,Shenyang 110004,China;Emergency Department,Shengjing Hospital,China Medical University,Shenyang 110004,China;Sleep Medicine Center,Shengjing Hospital,China Medical University,Shenyang110004,China)

机构地区：[1]中国医科大学附属盛京医院呼吸与危重病医学科,沈阳110004 [2]中国医科大学附属盛京医院急诊科,沈阳110004 [3]中国医科大学附属盛京医院睡眠医学中心,沈阳110004

出　　处：《中国医科大学学报》2020年第3期239-243,共5页Journal of China Medical University

基　　金：2019年度辽宁省重点研发指导计划(2019JH8/10300006)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并失眠患者的临床特点及相关因素。方法回顾性分析2017年3月至2018年3月因打鼾于我院睡眠医学中心就诊,经多导睡眠图监测确诊为OSAHS的382例患者的资料。根据患者主诉、病史、睡眠监测和早晨问卷分为单纯OSAHS组与OSAHS失眠共病组。应用统计学方法比较2组差异,并分析相关因素。结果2组患者在年龄、性别、并发高血压、冠状动脉粥样硬化性心脏病(冠心病)、晨起症状等方面的差异有统计学意义(P<0.05);OSAHS失眠共病的患者同时合并高血压、冠心病的概率较单纯OSAHS患者高,但排除了年龄这一混杂因素后则差异无统计学意义。多导睡眠监测结果中,OSAHS失眠共病患者的血氧饱和度低于90%的时间(TS90%)和呼吸暂停低通气指数(AHI)值更低,最低血氧饱和度(LSaO2)更高(P<0.05)。其中,TS90%是OSAHS合并失眠的独立相关因素。结论OSAHS失眠共病患者平均年龄较大,女性占比更高,且缺氧程度较单纯OSAHS患者轻,由于OSAHS患者中合并失眠的患者年龄较大,伴随高血压和冠心病也增多。TS90%可以作为OSAHS合并失眠的独立相关因素。Objective This study aimed to investigate the clinical features and relevant factors of comorbid obstructive sleep apnea hypopnea syndrome(OSAHS)and insomnia.Methods A retrospective analysis of 382 patients with OSAHS diagnosed using polysomnography(PSG)was performed at the Sleep Medicine Center of Shengjing Hospital affiliated to China Medical University from March 2017 to March 2018.According to the patient complaint,medical history,PSG result,and morning questionnaire,the OSAHS and“OSAHS comorbid with insomnia”groups were analyzed.We compared the differences between the two groups and analyzed the relevant factors.Results Significant differences in age,sex,hypertension,coronary heart disease,and morning symptoms were found between the OSAHS and“OSAHS comorbid with insomnia”groups(P<0.05).Compared to patients with insomnia,those without insomnia had a higher risk of coronary heart disease,but the difference was not statistically significant when age as the confounding factor was adjusted.Regarding the PSG results,patients with OSAHS who had insomnia had a lower percentage of sleep time spent below 90%oxygen saturation(TS90%)and apnea-hypopnea index and a higher blood oxygen saturation level(P<0.05)than those with OSAHS alone.TS90%is an independent relevant factor of OSAHS comorbid with insomnia.Conclusion Patients with comorbid OSAHS and insomnia were elderly and predominantly female.The degree of hypoxia in patients with OSAHS who had insomnia was milder than that in patients with OSAHS alone.As patients with OSAHS who showed insomnia symptoms were older,their risks of hypertension and coronary heart disease complications also increased.TS90%can be an independent relevant factor in comorbid OSAHS and insomnia.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 失眠 临床特点 相关因素 

分 类 号：R562.1[医药卫生—呼吸系统]