北京某高校教职工阻塞性睡眠呼吸暂停高危患者的健康管理效果初探  

Preliminary Study on Health Management Effect of High-Risk Patients of Obstructive Sleep Apnea in a University Staff in Beijing

作　　者：白雪 聂颖 李悦 孙亚慧 夏蓉晖 王露 孔令伟 Bai Xue;Nie Ying;Li Yue(Beijing Jiaotong University Community Health Service Center,Beijing 100044;Department of Otolaryngologica,Emergency General Hospital,Beijing 100028,China)

机构地区：[1]北京交通大学社区卫生服务中心,北京100044 [2]国家应急医学研究中心/应急总医院耳鼻喉科,北京100028

出　　处：《四川医学》2025年第3期321-326,共6页Sichuan Medical Journal

基　　金：北京市海淀区卫生健康发展科研培育计划(编号:HP2024-02-701001)。

摘　　要：目的探讨北京某高校肥胖合并慢性病的阻塞性睡眠呼吸暂停(OSA)高危教职工的健康管理效果。方法选取2022年9月至12月在北京交通大学社区卫生服务中心体检的、年龄20~79岁、体质指数(BMI)≥28 kg/m^(2),合并1种及以上慢性病(高血压、2型糖尿病、冠心病)的教职工,进行STOP-Bang问卷(SBQ),取其中OSA高危(≥3分)者,根据个人意愿分为对照组和干预组,前者给予健康宣教及慢性病管理,后者进一步进行便携式睡眠监测仪(PMD)检查,给予OSA个体化治疗及管理。1年后比较各项指标的变化。结果3256例教职工中,年龄在20~79岁,BMI≥28 kg/m^(2)的肥胖者共448例(13.8%)。肥胖人群中患有1种及以上慢性病者173例(38.6%),其中患高血压162例(36.2%)、糖尿病40例(8.9%)、冠心病13例(2.9%);筛查得到OSA高危77例。对照组45例,常规慢性病管理1年后,空腹血糖、血尿酸较基线显著降低(P<0.05);干预组32例,OSA个性化治疗1年后,运动人数、体质量、BMI、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、血尿酸及同型半胱氨酸显著优于基线(P<0.05)。随访1年,干预组BMI、血压、FBG显著优于对照组,差异有统计学意义(P<0.05)。干预组27例符合阻塞性睡眠呼吸暂停低通气综合征(OSAHS)诊断,总检出率84.4%,其中轻度7例,中度13例,重度7例。经过治疗后,OSA中度和重度组睡眠呼吸暂停通气指数、最低血氧饱和度均显著改善(P<0.05),后者CT90%值也显著改善(P<0.05)。结论利用SBQ及PMD检查对肥胖合并慢性病患者进行OSA高危筛查及管理是可行的,慢性病管理结合OSA个体化管理效果更显著。Objective To explore health management on high-risk OSA patients with obesity and chronic diseases in a university in Beijing.Methods From September to December 2022,general data were collected.Subjects were aged 20 to 79 years old with body mass index(BMI)≥28 kg/m^(2),patients with one or more chronic diseases(hypertension,type 2 diabetes,coronary heart disease),the STOP-Bang questionnaire defined as OSA high risk(≥3 points).According to whether they were willing to accept further diagnosis,treatment and health management for OSA,they were divided into intervention group(IG)and control group(CG).CG conducted health education and chronic disease management.On this basis,IG conducted further PMD examination,diagnosis,individualized treatment and management.Changes of each index after a year were obseved.Results Among 3256 subjects,448(13.8%)were aged 20~79 years with BMI≥28 kg/m^(2).Among obese population,173 cases(38.6%)had one or more chronic diseases,including 162 cases(36.2%)of hypertension,40 cases(8.9%)of diabetes,and 13 cases(2.9%)of coronary heart disease.77 cases with high risk of OSA were screened.In CG,45 cases had significantly lower fasting blood glucose and serum uric acid than baseline after 1 year of routine chronic disease management(P<0.05).In IG,32 cases had significantly better exercise number,weight,BMI,fasting blood glucose(FBG),total cholesterol,low density lipoprotein cholesterol,serum uric acid,and homocysteine after 1 year of personalized OSA treatment(P<0.05).After 1 year of follow-up,BMI,blood pressure,and FBG in IG were significantly better than those in CG,with statistically significant differences(P<0.05).In IG,27 cases were diagnosed with OSA,with a total detection rate of 84.4%,including 7 cases of mild,13 cases of moderate,and 7 cases of severe.After treatment,apnea-hypopnea index and minimum oxygen saturation in the moderate and severe OSA groups were significantly improved(P<0.05),and the latter CT 90%value was also significantly improved(P<0.05).Conclusion It is feasible

关 键 词：阻塞性睡眠呼吸暂停 STOP-Bang问卷 便携式睡眠监测仪 慢性病管理 

分 类 号：R766[医药卫生—耳鼻咽喉科]