重叠综合征患者夜间缺氧和睡眠结构的分析  

Analysis of night-time hypoxemia and sleeping characteristics of patients with overlapping syndrome

作　　者：王佳[1] 林建海[1] 鲁慧敏[1] 

机构地区：[1]上海第二医科大学附属新华医院呼吸科,200092

出　　处：《上海医学》2003年第12期899-901,共3页Shanghai Medical Journal

摘　　要：目的　探讨重叠综合征 (OS)患者夜间缺氧和睡眠结构的变化。方法　对 19例OS、2 5例阻塞性睡眠呼吸暂停综合征 (OSAS)、17例慢性阻塞性肺疾病 (COPD)和 14例鼾症患者分别进行全夜多导睡眠仪 (PSG)检查 ,并对各组数据作统计学t检验。结果　单纯鼾症患者基本不存在日间或夜间缺氧 (P <0 .0 5 ) ;OSAS患者最低动脉血氧饱和度 (SaO2 L)显著低于COPD患者 (P <0 .0 1) ,最长呼吸暂停时间 (TL)、总睡眠时间 (TST)和睡眠效率 (SE)显著高于COPD患者 (P <0 .0 1) ,OS患者SaO2 L、深睡眠所占百分率 (S3+ 4 )显著低于COPD患者 (P <0 .0 1) ,动脉血氧饱和度 (SaO2 ) <90 %累计时间的百分率 (SLT90 % )、SaO2 <80 %累计时间占睡眠时间的百分率 (SLT80 % )及浅睡眠所占百分率 (S1+ 2 )显著高于COPD患者 (P <0 .0 1)。OS患者SLT90 %、S1+ 2显著高于OSAS患者 (P <0 .0 1) ,睡眠效率显著低于OSAS患者 (P <0 .0 1)。结论　OS患者夜间缺氧较严重 ,睡眠结构改变明显。Objective To investigate night time hypoxemia and change of sleeping characteristics of the patients with overlapping syndrome. Methods 25 patients with obstructive sleeping apnea syndrome(OSAS), 19 with overlapping syndrome,17 with chronic obstructive pulmonary disease (COPD) and 14 with snoring were monitored and diagnosed by nocturnal polysomnography (PSG). The data of each group was assessed by t test, respectively. Results The patients with simple snoring had no hypoxemia ( P <0.05). The longest apnea time(TL), total sleeping time(TST), sleeping efficiency(SE) in patients with OSAS were much longer and higher than those in COPD patients ( P <0.01); but the lowest oxygen saturation (SaO 2L) was significantly lower than that of COPD patients ( P <0.01). The levels of SaO 2L, percentage of deep sleep (S3+4) in patients with overlapping syndrome were much lower than those of COPD patients ( P <0.01); the percentage of cumulated time when SaO 2 was lower than 90% (SLT90%), the percentage of cumulated time when SaO 2 was lower than 80% (SLT80%) and percentage of light sleep (S1+2) in these patients were much higher than those in COPD patients ( P <0.01). The levels of SLT90% and S1+2 in patients with overlapping syndrome were significantly higher than those in OSAS patients ( P <0.01); the SE was significantly lower than that in the patients of OSAS. Conclusion This study shows that patients with overlapping syndrome have more severe night time hypoxemia and more significant changes in sleeping characteristics.

关 键 词：重叠综合征 夜间缺氧 睡眠结构 阻塞性睡眠呼吸暂停综合征 慢性阻塞性肺疾病 鼾症 多导睡眠仪 夜间低氧血症 

分 类 号：R56[医药卫生—呼吸系统]