阻塞性睡眠呼吸暂停低通气综合征患者Epworth嗜睡评分与甲状腺激素的相关性  

Correlation between Epworth sleepiness score and thyroid hormones in patients with obstructive sleep apnea hypopnea syndrome

作　　者：王海月 燕存子[1] 戴月梅[1] 夏宇[1] 孙峰[1] 王在义[1] Wang Haiyue;Yan Cunzi;Dai Yuemei;Xia Yu;Sun Feng;Wang Zaiyi(Respiratory and Respiratory Critical Care Center,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830054,China)

机构地区：[1]新疆医科大学第一附属医院呼吸与呼吸危重症中心,乌鲁木齐830054

出　　处：《疑难病杂志》2021年第3期232-236,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：新疆维吾尔自治区自然科学基金项目(2018D01C207)。

摘　　要：目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者甲状腺激素水平与患者Epworth嗜睡评分(ESS)的关系。方法选取2018年1月—2019年12月新疆医科大学第一附属医院呼吸与呼吸危重症中心收治OSAHS患者83例为研究对象,入院时参照ESS评分评估患者嗜睡程度,分为轻度嗜睡组(n=51)和中重度嗜睡组(n=32);采集患者基线资料,比较各组血清促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、瘦素水平,并分析甲状腺激素水平与ESS评分的相关性。结果中重度嗜睡组TSH、FT_(4)水平低于轻度嗜睡组,瘦素水平高于轻度嗜睡组(t=3.942、5.252、8.661,P均<0.001);TSH、FT_(4)水平与OSAHS患者ESS评分呈负相关(r=-0.526、-0.500,P均<0.001);TSH、FT_(4)低表达,瘦素过表达是患者嗜睡程度加重的危险因素(OR=18.401、12.096、54.493,P均<0.05)。TSH、FT_(4)预测OSAHS患者嗜睡程度加重风险的AUC分别为0.896、0.873,两者联合检测的AUC为0.901。结论OSAHS患者的甲状腺激素(TSH、FT_(4))水平与ESS评分呈负相关,TSH、FT_(4)低表达可能提示OSAHS患者嗜睡程度加重。Objective To detect thyroid hormone levels in patients with obstructive sleep apnea hypopnea syndrome(OSAHS),to analyze the relationship between thyroid hormone levels and the Epworth Sleepiness Score(ESS)of patients.Methods 83 patients with OSAHS admitted to the Respiratory and Respiratory Critical Care Center of the First Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2019 were selected as the research subjects;on admission,referred to the ESS score to evaluate the sleepiness of the patients and divided them into groups;collected baseline data of patients,compared various laboratory indicators,focused on comparing the levels of thyroid hormones[serum thyroid stimulating hormone(TSH),free triiodothyronine(FT_(3)),free thyroxine(FT_(4))],and analyzed the correlation between thyroid hormone levels and ESS score.Results Among 83 OSAHS patients,51 cases were mild sleepiness;32 cases were moderate to severe sleepiness;the TSH and FT_(4)levels of the moderate to severe sleepiness group were lower than those of the mild sleepiness group,and the leptin level was higher than that of the mild sleepiness group(t=3.942,5.252,8.661,both P<0.001);thyroid hormones(TSH,FT_(4))were negatively correlated with the ESS score of OSAHS patients(r=-0.526,-0.500,all P<0.001);low expression of TSH and FT_(4)and overexpression of leptin were the influencing factors for the aggravation of sleepiness in patients(OR=18.401,12.096,54.492,P<0.05);the combination of TSH and FT_(4)predicted the AUC of the risk of increased sleepiness in OSAHS patients were 0.901,which were higher than 0.896 and 0.873 of TSH and FT_(4).Conclusion The level of thyroid hormones(TSH,FT_(4))in OSAHS patients is negatively correlated with the ESS score.Low expression of TSH and FT_(4)may indicate the risk of increased degree of sleepiness in OSAHS patients.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 Epworth嗜睡评分 甲状腺激素 相关性 

分 类 号：R562.1[医药卫生—呼吸系统]