基于倾向性得分匹配法分析阻塞性睡眠呼吸暂停对死亡的影响  

Effect of obstructive sleep apnea on death based on propensity score matching

作　　者：蒋雪龙 王勤 张庆龙 何忠明[1] JIANG Xuelong;WANG Qin;ZHANG Qinglong;HE Zhongming(Department of Respiratory and Critical Care Medicine,Karamay Central Hospital,Karamay,Xinjiang 834000,China)

机构地区：[1]克拉玛依市中心医院,新疆克拉玛依834000

出　　处：《临床肺科杂志》2023年第12期1815-1818,共4页Journal of Clinical Pulmonary Medicine

基　　金：国家自然科学基金(No.82160023);新疆维吾尔自治区自然科学基金项目(No.2020D01B06)克拉玛依市首届科技创新人才项目。

摘　　要：目的探讨阻塞性睡眠呼吸暂停死亡的影响因素。方法自2008年1月对克拉玛依市区35岁以上1331例睡眠呼吸暂停流调的患者进行随访,使用便携式睡眠呼吸监测仪进行监测,随访终点时间为2020年12月,检查指标包括呼吸暂停低通气指数(AHI)、氧减饱和度指数(ODI4%),平均氧饱和度(MSaO_(2))、最低氧饱和度(LSaO_(2))、颈围、腹围及体质量指数(BMI)。按是否存活分为生存组和死亡组,采用倾向性得分匹配法(PSM)对基线数据进行匹配。结果1331例研究对象,失访382例,最终纳入949例,死亡255例。匹配前年龄、性别、颈围、腹围,差异有统计学意义(P<0.05);匹配后年龄、性别、颈围、腹围,差异无统计学意义(P>0.05)。匹配后生存组与死亡组AHI[(12.57±15.02)次/h vs(16.91±18.48)次/h]、ODI4%[(7.73±8.38)次/h vs(9.76±10.92)次/h]比较,差异有统计学意义(P<0.05)。结论ODI4%、AHI可用于评估OSA死亡风险,OID4%、AHI越高死亡风险越高。Objective To explore the influencing factors of death in obstructive sleep apnea.Methods From January 2008,it monitored the sleep date of 1331 patients with sleep apnea over the age of 35 in Karamay by using the portable sleep breathing monitor.The follow-up endpoint was December 2020.The examination indexes included apnea hypopnea index(AHI),oxygen reduction index(ODI4%),mean oxygen saturation(MSaO_(2)),lowest oxygen saturation(LSaO_(2)),neck circumference,abdominal circumference and body mass index(BMI).Divided into survival group and death group according to survival outcome.Propensity score matching(PSM)was applied to match the baseline data of patients in the 2 groups.Results In 1331 subjects,382cases were lost to follow-up,949cases were finally included,and 255cases of death reported.There were significant differences in age,sex,neck circumference and abdominal circumference before matching(P<0.05).There were no significant difference in age,sex,neck circumference and abdominal circumference after matching(P>0.05).After matching,AHI[(12.57±15.02)times/h vs(16.91±18.48)times/h]and ODI4%[(7.73±8.38)times/h vs(9.76±10.9)times/h]in the survival group and the death group were significantly different(P<0.05).Conclusion ODI4%and AHI can be used to assess the risk of OSA death.The higher the OID4%and AHI,the higher the risk of death in OSA patients.

关 键 词：睡眠呼吸暂停 死亡 呼吸紊乱指数 氧减指数 倾向性得分匹配法 

分 类 号：R766[医药卫生—耳鼻咽喉科]