成年男性OSAHS患者日間嗜睡相關因素分析
發(fā)布時間：2018-11-23 09:37
【摘要】：目的:分析阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者日間嗜睡(EDS)相關因素。探討OSAHS患者EDS與年齡、體塊指數(shù)(BMI)、呼吸暫停低通氣指數(shù)(AHI)、呼吸暫停指數(shù)(AI)、低通氣指數(shù)(HI)、夜間最低血氧飽和度(最低Sp02)、夜間平均血氧飽和度(平均Sp0_2)、血氧飽和度低于90%的時間占總睡眠時間的百分比(TS90)、微覺醒、非快動眼睡眠1期占總睡眠時間的比值(S1%),非快動眼睡眠2期占總睡眠時間的比值(S2%),非快動眼睡眠1和2期占總睡眠時間的比值(S1+2%),非快動眼睡眠3和4期占總睡眠時間的比值(S3+4%),快動眼睡眠時間占總睡眠時間的比值(REM%)、睡眠效率相關性。 方法:通過多導睡眠監(jiān)測診斷OSAHS,行Epworth嗜睡評分量表問卷調查,并測量身高、體重,計算體塊指數(shù)(BMI)。依據(jù)Epworth嗜睡量表得分,將64例成年男性OSAHS患者劃分為無嗜睡組、輕度嗜睡組、中度嗜睡組及重度嗜睡組。血氧飽和度和呼吸暫停低通氣指數(shù)按照國內2002年制定的《阻塞性睡眠呼吸暫停低通氣綜合征診治指南》分組,分為正常血氧組,輕度低血氧組,中度低血氧組及重度低血氧組;AHI輕度,中度及重度。分析影響OSAHS患者日間嗜睡因素。 結果:入選OSAHS患者中,輕、中度嗜睡例數(shù)占較大比例。四組不同嗜睡程度的OSAHS患者AHI、AI、TS90隨嗜睡程度的加重而增高。重度嗜睡組的AHI、TS90與無嗜睡組比較,差別有統(tǒng)計學意義(P0.05),而輕、中度嗜睡組與無嗜睡組比較無統(tǒng)計學差異。中、重度嗜睡組和無嗜睡組的AI比較,有統(tǒng)計學意義,而輕度嗜睡組與無嗜睡組比較無統(tǒng)計學意義。重度嗜睡組和無嗜睡組的平均Sp02比較有顯著差異(P0.05),而輕、中度嗜睡組與無嗜睡組比較無統(tǒng)計學差異。重度嗜睡組和無嗜睡組S1+2%比較,有統(tǒng)計學意義(t=-2.402, P0.05),而輕、中度嗜睡組與無嗜睡組比較無統(tǒng)計學差異。中、重度嗜睡組S3+4%、睡眠效率分別與無嗜睡組比較,有統(tǒng)計學差異(P0.05),輕度嗜睡組與無嗜睡組比較無統(tǒng)計學差異。不同程度的平均血氧飽和度的OSAHS患者ESS評分隨著平均血氧飽和度的下降ESS評分增高,中、重度低血氧組分別與正常血氧組比較,有統(tǒng)計學差異,P0.05。而不同程度最低血氧飽和度的OSAHS患者組間ESS評分無統(tǒng)計學差異。S1+2期睡眠所占睡眠時間百分比隨嗜睡程度加重而增高,睡眠效率、S3+4期睡眠所占睡眠時間百分比隨嗜睡程度加重而降低。ESS評分與AHI、AI、HI、TS90呈正相關。ESS評分與平均Sp0_2、睡眠效率呈負相關。排除混雜因素后,嗜睡程度和AHI、TS90呈正相關,和睡眠效率呈負相關。與睡眠微覺醒關性較差。 結論: OSAHS患者EDS與AHI、AI、夜間最低Sp02、夜間平均Sp0_2、TS90、S1+2%、S3+4%、睡眠效率關系密切。以上因素影響OSAHS患者的EDS的嚴重程度。AHI越高,低氧血癥越重且持續(xù)的時間越長,淺睡眠所占比例越大,深睡眠所占比例越小,睡眠效率越差,OSAHS患者EDS越重。
[Abstract]:Objective: to analyze the related factors of daytime sleepiness (EDS) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To investigate the relationship between EDS and age, body mass index (BMI), apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI), nocturnal minimum oxygen saturation (minimum Sp02) in patients with OSAHS. The mean nocturnal oxygen saturation (Sp0_2), the percentage of time below 90% of total sleep time (TS90), the ratio of microarousal, non-rapid eye movement sleep stage 1 to total sleep time (S1%), The ratio of non-REM sleep stage 2 to total sleep time (S2%), non-REM sleep stage 1 and stage 2 to total sleep time (S 1 2%), non-rapid eye sleep stage 3 and 4 to total sleep time (S 3 4%), The ratio of REM sleep time to total sleep time (REM%) was correlated with sleep efficiency. Methods: polysomnography diagnosis OSAHS, was investigated with Epworth somnolence scale, height, weight and mass index (BMI). Were calculated. According to the scores of Epworth somnolence scale, 64 adult male patients with OSAHS were divided into three groups: no sleepiness group, mild somnolence group, moderate somnolence group and severe sleepiness group. According to the guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (OSAS), the patients were divided into normal oxygen group, mild hypoxic group, moderate hypoxic group and severe hypoxic group according to the guidelines for diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (OSAS). AHI is mild, moderate and severe. The factors affecting daytime sleepiness in OSAHS patients were analyzed. Results: mild and moderate somnolence was more common in patients with OSAHS. AHI,AI,TS90 increased with the aggravation of somnolence in four groups of OSAHS patients with different degrees of somnolence. The AHI,TS90 of severe somnolence group was significantly higher than that of non-somnolence group (P0.05), but there was no significant difference between mild and moderate somnolence group and non-somnolence group. There was significant difference in AI between moderate and severe sleepiness group and no somnolence group, but there was no significant difference between mild somnolence group and non-somnolence group. There was significant difference in average Sp02 between severe sleepiness group and non somnolence group (P0.05), but there was no significant difference between mild and moderate somnolence group and no somnolence group. There was significant difference between severe sleepiness group and non-somnolence group in S _ 1 _ 2% (tng-2.402, P0.05), but there was no statistical difference between mild and moderate sleepiness group and non-somnolence group. There were significant differences in sleep efficiency between moderate and severe narcolepsy group compared with non-sleepiness group (P0.05), while there was no significant difference between mild sleepiness group and non-somnolence group. The ESS score of OSAHS patients with different degrees of mean oxygen saturation increased with the decrease of mean oxygen saturation. There was significant difference between moderate and severe hypoxic group and normal oxygen group (P 0.05). However, there was no significant difference in ESS score among OSAHS patients with different degrees of lowest oxygen saturation. The percentage of sleep time in stage S1 2 sleep increased with the increase of somnolence, and the sleep efficiency increased. The percentage of sleep time in S34 sleep decreased with the severity of somnolence. The ESS score was positively correlated with AHI,AI,HI,TS90, and the ESS score was negatively correlated with the average Sp0_2, sleep efficiency. After exclusion of confounding factors, somnolence was positively correlated with AHI,TS90 and negatively correlated with sleep efficiency. Poor correlation with sleep microarousal. Conclusion: EDS in patients with OSAHS has a close relationship with the nocturnal average of Sp0_2,TS90,S1 _ 2 and S _ 34 of lowest Sp02, in AHI,AI, and sleep efficiency is closely related. The higher the AHI, the more serious the hypoxemia, the longer the duration, the larger the proportion of shallow sleep, the smaller the proportion of deep sleep, the worse the sleep efficiency, and the more serious EDS in OSAHS patients.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R766
本文編號：2351102
[Abstract]:Objective: to analyze the related factors of daytime sleepiness (EDS) in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). To investigate the relationship between EDS and age, body mass index (BMI), apnea hypopnea index (AHI), apnea index (AI), hypopnea index (HI), nocturnal minimum oxygen saturation (minimum Sp02) in patients with OSAHS. The mean nocturnal oxygen saturation (Sp0_2), the percentage of time below 90% of total sleep time (TS90), the ratio of microarousal, non-rapid eye movement sleep stage 1 to total sleep time (S1%), The ratio of non-REM sleep stage 2 to total sleep time (S2%), non-REM sleep stage 1 and stage 2 to total sleep time (S 1 2%), non-rapid eye sleep stage 3 and 4 to total sleep time (S 3 4%), The ratio of REM sleep time to total sleep time (REM%) was correlated with sleep efficiency. Methods: polysomnography diagnosis OSAHS, was investigated with Epworth somnolence scale, height, weight and mass index (BMI). Were calculated. According to the scores of Epworth somnolence scale, 64 adult male patients with OSAHS were divided into three groups: no sleepiness group, mild somnolence group, moderate somnolence group and severe sleepiness group. According to the guidelines for the diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (OSAS), the patients were divided into normal oxygen group, mild hypoxic group, moderate hypoxic group and severe hypoxic group according to the guidelines for diagnosis and treatment of obstructive sleep apnea hypopnea syndrome (OSAS). AHI is mild, moderate and severe. The factors affecting daytime sleepiness in OSAHS patients were analyzed. Results: mild and moderate somnolence was more common in patients with OSAHS. AHI,AI,TS90 increased with the aggravation of somnolence in four groups of OSAHS patients with different degrees of somnolence. The AHI,TS90 of severe somnolence group was significantly higher than that of non-somnolence group (P0.05), but there was no significant difference between mild and moderate somnolence group and non-somnolence group. There was significant difference in AI between moderate and severe sleepiness group and no somnolence group, but there was no significant difference between mild somnolence group and non-somnolence group. There was significant difference in average Sp02 between severe sleepiness group and non somnolence group (P0.05), but there was no significant difference between mild and moderate somnolence group and no somnolence group. There was significant difference between severe sleepiness group and non-somnolence group in S _ 1 _ 2% (tng-2.402, P0.05), but there was no statistical difference between mild and moderate sleepiness group and non-somnolence group. There were significant differences in sleep efficiency between moderate and severe narcolepsy group compared with non-sleepiness group (P0.05), while there was no significant difference between mild sleepiness group and non-somnolence group. The ESS score of OSAHS patients with different degrees of mean oxygen saturation increased with the decrease of mean oxygen saturation. There was significant difference between moderate and severe hypoxic group and normal oxygen group (P 0.05). However, there was no significant difference in ESS score among OSAHS patients with different degrees of lowest oxygen saturation. The percentage of sleep time in stage S1 2 sleep increased with the increase of somnolence, and the sleep efficiency increased. The percentage of sleep time in S34 sleep decreased with the severity of somnolence. The ESS score was positively correlated with AHI,AI,HI,TS90, and the ESS score was negatively correlated with the average Sp0_2, sleep efficiency. After exclusion of confounding factors, somnolence was positively correlated with AHI,TS90 and negatively correlated with sleep efficiency. Poor correlation with sleep microarousal. Conclusion: EDS in patients with OSAHS has a close relationship with the nocturnal average of Sp0_2,TS90,S1 _ 2 and S _ 34 of lowest Sp02, in AHI,AI, and sleep efficiency is closely related. The higher the AHI, the more serious the hypoxemia, the longer the duration, the larger the proportion of shallow sleep, the smaller the proportion of deep sleep, the worse the sleep efficiency, and the more serious EDS in OSAHS patients.
【學位授予單位】：吉林大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R766
【參考文獻】
相關期刊論文 前10條
1 胡寶明;葉京英;丁秀;張玉煥;王江泳;王立曼;李鴻光;;阻塞性睡眠呼吸暫停低通氣綜合征患者生活質量的相關性研究[J];中國耳鼻咽喉頭頸外科;2006年07期
2 肖毅;黃蓉;鐘旭;;阻塞性睡眠呼吸暫停低通氣綜合征患者睡眠片段的評估-脈搏傳導時間微覺醒[J];國際呼吸雜志;2006年09期
3 鄭明秀;王玫;;阻塞性睡眠呼吸暫停低通氣綜合征與肥胖及血清抵抗素水平關系的研究[J];臨床耳鼻咽喉頭頸外科雜志;2008年02期
4 董硯虎,孫黎明,李利;肥胖的新定義及亞太地區(qū)肥胖診斷的重新評估與探討[J];遼寧實用糖尿病雜志;2001年02期
5 胡芳;楊宇;羅熒荃;;氧減飽和度指數(shù)對睡眠呼吸暫停低通氣綜合征的診斷價值[J];實用預防醫(yī)學;2007年02期
6 王巍;張玉庚;;阻塞性睡眠呼吸暫停低通氣綜合征研究進展[J];天津醫(yī)藥;2009年03期
7 ;阻塞性睡眠呼吸暫停低通氣綜合征診斷依據(jù)和療效評定標準暨懸雍垂腭咽成形術適應證(杭州)[J];中華耳鼻咽喉科雜志;2002年06期
8 中華醫(yī)學會呼吸病學分會睡眠呼吸疾病學組;阻塞性睡眠呼吸暫停低通氣綜合征診治指南(草案)[J];中華結核和呼吸雜志;2002年04期
9 歐瓊,黃平,鄭勤偉,高興林;中老年人阻塞性睡眠呼吸暫停低通氣綜合征白天嗜睡的臨床分析[J];中華老年醫(yī)學雜志;2004年07期
10 中華醫(yī)學會呼吸病學分會睡眠呼吸疾病學組;阻塞性睡眠呼吸暫停低通氣綜合征診治指南(草案)[J];中華內科雜志;2003年08期
，本文編號：2351102
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