睡眠呼吸暂停患者脑电梭形波与疾病严重程度的关系  

The Relationship Between Obstructive Sleep Apnea and Sleep Spindles

作　　者：程益潞 欧琼[2,1] 许燕霞 劳妙婵 裴果[1,2] CHENG Yi-lu;OU Qiong;XU Yan-xia;LAO Miao-chan;PEI Guo(School of Medicine,South China University of Technology,Guangzhou 510006,China;Guangdong Provincial Geriatrics Institute,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,China)

机构地区：[1]华南理工大学医学院,广州510006 [2]广东省人民医院(广东省医学科学院),广东省老年医学研究所,广州510080

出　　处：《循证医学》2021年第3期184-188,共5页The Journal of Evidence-Based Medicine

基　　金：国家自然科学基金面上项目(81870077);广东省科技厅公益研究与能力建设资助项目(2016A020216030)。

摘　　要：目的分析阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)患者梭形波的变化,探讨其与疾病严重程度的关系。方法研究纳入了2019年7月至2021年4月就诊于广东省人民医院睡眠中心并采用Phillips Alice 6 LDXS设备进行多导睡眠监测的患者。患者年龄18~65岁,未合并除OSA外的其他睡眠障碍或精神类疾病。将符合标准的患者根据呼吸暂停低通气指数(apnea-hypopnea index,AHI)分为正常对照组(AHI<5)、轻度(5≤AHI<15)、中度(15≤AHI<30)和重度(AHI≥30)OSA组。结果共计入组252例患者,平均年龄为44.8±11.7岁,平均体质量指数(body mass index,BMI)为25.5±3.8 kg/m^(2),平均AHI为28.6±23.2次/时。正常对照组33例,轻度OSA患者58例,中度60例,重度101例。对照组、轻度、中度及重度各组的梭形波数量依次为411.0(151.5,1569.5)、315.5(150.0,667.8)、251.0(96.0,680.8)、224.0(75.0,567.5),P=0.002;各组梭形波密度分别为2.6(0.7,7.4)、1.6(0.7,2.9)、1.2(0.4,3.7)、0.9(0.3,2.5),P<0.001。N2期梭形波密度随着AHI和BMI的升高而下降(P值分别为0.028及0.012)。结论重度OSA患者的N2期梭形波数量和密度显著下降,且N2期梭形波密度存在随着AHI和BMI的升高而降低的趋势。Objective To access the changes of sleep spindles in patients with obstructive sleep apnea(OSA).Methods This is an observational,cross-sectional study consecutively recruited out patients at the sleep center of Guangdong Provincial People's Hospital,China between July 2019 and April 2021.Patients were aged 18~65 years and underwent overnight polysomnography(PSG)by Phillips Alice 6 LDXS.Exclusion criteria were any sleep disorder or mental health issues other than OSA including current treatment for sleep apnea,insomnia and depression.Subjects who reported taking sleep aids were also exclude.The participants were divided into four groups according to their apneahypopnea index(AHI):normal(AHI<5),mild(5≤AHI<15),moderate(15≤AHI<30),and severe(AHI≥30).Oneway ANOVA or nonparametric test was used for comparison between groups.Associations between sleep spindles and other parameters were analyzed with a general linear model.Results 252 adults were included(33 in normal group,58 had mild OSA,60 had moderate OSA and 101 had severe OSA)with the mean age 44.8±11.7 years,mean body mass index(BMI)25.5±3.8 kg/m^(2) and mean AHI 28.6±23.2/h.The numbers of sleep spindles in N2 was 411.0(151.5,1569.5)in the normal,315.5(150.0,667.8)in the mild,251.0(96.0,680.8)in the moderate,224.0(75.0,567.5)in the severe,with significance between group difference(P=0.002).The destiny of sleep spindles in N2 was 2.6(0.7,7.4)in the normal,1.6(0.7,2.9)in the mild,1.2(0.4,3.7)in the moderate and 0.9(0.3,2.5)in the severe,with significance between group difference(P<0.001).There was a trend that the destiny of sleep spindles in N2 decreased with the increase of AHI(P=0.028)and BMI(P=0.012).Conclusions The number and destiny of sleep spindles in N2 had a significant decrease in severe OSA patients and the destiny of sleep spindles in N2 decreased with the increase of AHI and BMI.

关 键 词：阻塞性睡眠呼吸暂停 梭形波 多导睡眠图 

分 类 号：R56[医药卫生—呼吸系统]