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目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者日间嗜睡与夜间缺氧程度及疾病严重程度的关系。方法对2007年7月至2008年1月中国医科大学附属第一医院呼吸内科经多导睡眠呼吸监测确诊的32例男性OSAHS患者与10例单纯鼾症男性对照者进行嗜睡评分以及全夜多导睡眠监测,根据不同睡眠呼吸暂停低通气指数(AHI)分组,比较其嗜睡情况与驾驶车辆能力,并与AHI和夜间低氧程度进行相关分析。结果(1)OSAHS组驾驶车辆能力下降、嗜睡评分明显高于对照组[(15.34±4.80)分对(7.60±4.65)分,P<0.05],并且随着AHI的增加(r=0.782,P<0.001)、最低血氧饱和度的降低(r=-0.744,P<0.001),其嗜睡评分增加。(2)多元逐步回归表明,AHI、最低血氧与患者日间嗜睡程度密切相关,其回归方程为Y(日间嗜睡评分)=19.441-0.132X1(最低血氧饱和度)+0.109X2(AHI)(R2=0.651,P<0.05)。结论(1)OSAHS患者有较大的驾车安全隐患,并且重度的OSAHS患者尤为明显。(2)OSAHS患者日间嗜睡程度与AHI和最低血氧均密切相关。
Objective To investigate the relationship between daytime sleepiness and nocturnal hypoxia and disease severity in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods From July 2007 to January 2008, 32 patients with OSAHS diagnosed by polysomnography and respiratory diseases in the First Affiliated Hospital of China Medical University and 10 male patients with simple snore were evaluated for drowsiness score, Sleep monitoring, based on different sleep apnea-hypopnea index (AHI) groups, to compare their lethargy and driving ability, and with AHI and night-time hypoxia level correlation analysis. Results: (1) The capacity of driving vehicle in OSAHS group was significantly lower than that of control group [(15.34 ± 4.80) vs 7.60 ± 4.65, P <0.05], and with the increase of AHI (r = 0.782, P <0.001), the lowest oxygen saturation (r = -0.744, P <0.001), and the drowsiness score increased. (2) Multiple stepwise regression showed that the AHI and minimum oxygen saturation were closely related to the degree of daytime sleepiness. The regression equation was Y (daytime sleepiness score) = 19.441-0.132X1 (lowest oxygen saturation) + 0.109X2 (AHI ) (R2 = 0.651, P <0.05). Conclusion (1) OSAHS patients have greater risk of driving safety, and severe OSAHS patients is particularly evident. (2) The degree of daytime sleepiness in patients with OSAHS is closely related to AHI and minimum oxygen level.