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目的研究重度阻塞性睡眠呼吸暂停低通气综合征(severe obstructive sleep apneahypopnea syndrome,SOSAHS)患者呼吸事件的发生与睡眠时相、睡眠体位的关系。方法经多导睡眠监测确诊的61例SOSAHS患者。按是否为体位依赖的OSAHS(仰卧位AHI/非仰卧位AHI≥2)分为2组,即体位依赖(positional patient,PP)组和非体位依赖(nonpositional patient,NPP)组,分别比较各组间年龄、体重指数(BMI)、颈围(NC)、快动眼睡眠期(REM)呼吸暂停低通气指数(AHI)、非快动眼睡眠期(NREM)AHI、最低血氧饱和度(Lowest oxygen saturation,LSaO2)等参数。组内各参数进行相关性分析。结果 PP组BMI明显大于NPP组(t=11.786,P<0.05),而年龄、AHI、LSaO2等参数无明显统计学差异。PP组颈围与呼吸暂停指数(AI)和AHI呈显著正相关(r=0.534,0.536,P<0.05),NREM AHI与AI、AHI和LSaO2呈显著相关性(r=0.758,0.879,-0.484,P<0.05)。结论重度OSAHS患者中,除BMI外体位依赖的OSAHS患者无特殊临床特征,颈围大小影响体位依赖的OSAHS患者病情程度。
Objective To study the relationship between the occurrence of respiratory events and the phases of sleep and sleep in patients with severe obstructive sleep apnea hypopnea syndrome (SOSAHS). Methods Sixty-one SOSAHS patients diagnosed by polysomnography. Patients were divided into two groups according to OSAHS (AHI in supine position and AHI≥2 in non-supine position) according to whether they were position-dependent (PP) or non-positional (NPP) Age, body mass index (BMI), neck circumference (NC), REM sleep apnea hypopnea index (AHI), NREM AHI and Lowest Oxygen Saturation oxygen saturation, LSaO2) and other parameters. The parameters of the group were analyzed. Results The BMI in PP group was significantly higher than that in NPP group (t = 11.786, P <0.05), while there was no significant difference in age, AHI, LSaO2 and other parameters. There was a significant positive correlation between neck circumference and apnea index (AI) and AHI (r = 0.534,0.536, P <0.05) in PP group, and significant correlation between NREM AHI and AI, AHI and LSaO2 (r = 0.758,0.879, , P <0.05). Conclusion There are no special clinical features in OSAHS patients with OSAHS except for BMI in severe OSAHS patients. The size of neck circumference affects the severity of OSAHS patients.