影响阻塞性睡眠呼吸暂停低通气综合征患者日间嗜睡的危险因素分析  

Analysis of risk factors affecting daytime sleepiness in patients with obstructive sleep apnea-hypopnea syndrome

作　　者：叶灵 竺飞燕[1] 金鑫[1] 金金[1] 王瑶瑶 YE Ling;ZHU Feiyan;JIN Xin;JIN Jin;WANG Yaoyao(Department of Neurology,Tongde Hospital of Zhejiang Province,Hangzhou 310012,China)

机构地区：[1]浙江省立同德医院神经内科,浙江杭州310012

出　　处：《中国现代医生》2022年第7期40-42,181,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019KY343)。

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者日间嗜睡的危险因素。方法选取2019年1月至2020年10月浙江省立同德医院收治的196例OSAHS患者进行临床随访调查,均进行Epworth嗜睡量表(ESS)评估,依据其是否发生日间嗜睡将其分为嗜睡组(n=102)和无嗜睡组(n=94);比较两组间的年龄、体质量指数、吸烟、饮酒、糖尿病、高血压、心脑血管疾病、AHI、MSaO_(2)、LSaO_(2)、CT90、总呼吸暂停低通气时间、最长呼吸暂停时间、总睡眠时间、微觉醒指数等因素;并采用逐步logistic回归法筛选影响OSAHS患者日间嗜睡的危险因素。结果196例OSAHS患者日间嗜睡发生率为52.04%(102/196);多因素结果显示,影响OSAHS患者日间嗜睡的危险因素包括体质量指数(OR=4.280)、高血压(OR=3.025)、AHI(OR=1.670)、CT90(OR=2.113)、总呼吸暂停低通气时间(OR=1.528)、微觉醒指数(OR=2.843),而LSaO_(2)(OR=0.383)则为保护因素。结论OSAHS患者具有很高的日间嗜睡率,影响其日间嗜睡的高危因素较多,应根据这些危险因素进行积极预防和治疗,降低OSAHS患者的日间嗜睡率,提高其生活质量。Objective To investigate the risk factors of daytime sleepiness in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods A total of 196 patients with OSAHS admitted to Tongde Hospital of Zhejiang Province from January 2019 to October 2020 were selected for the clinical follow-up survey.All patients underwent Epworth Sleepiness Scale(ESS)assessment.They were divided into the sleepiness group(n=102)and no sleepiness group(n=94)according to whether daytime sleepiness occurred.Age,body mass index,smoking,alcohol consumption,diabetes,hypertension,cardiovascular and cerebrovascular diseases,AHI,MSaO_(2),LSaO_(2),CT90,total apnea-hypopnea time,the longest apnea time,total sleep time,arousal index,and other factors were compared between the two groups.The stepwise logistic regression method was used to screen the risk factors affecting daytime sleepiness in patients with OSAHS.Results The incidence of daytime sleepiness in 196 patients with OSAHS was 52.04%(102/196).Multivariate results showed that the risk factors affecting daytime sleepiness in patients with OSAHS included body mass index(OR=4.280),hypertension(OR=3.025),AHI(OR=1.670),CT90(OR=2.113),total apnea-hypopnea time(OR=1.528),and arousal index(OR=2.843).While LSaO_(2)(OR=0.383)was a protective factor.Conclusion OSAHS patients have a high rate of daytime sleepiness,and there are many factors affecting daytime sleepiness.Active prevention and treatment should be performed according to these risk factors to reduce the rate of daytime sleepiness and improve the quality of life of OSAHS patients.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 日间嗜睡 睡眠片段化 危险因素 

分 类 号：R766.7[医药卫生—耳鼻咽喉科]