Recurrent pulmonary edema associated with obstructive sleep apnea syndrome]

A 70-year-old non-obese man with no history of cardiopulmonary disease presented 4 times to the emergency room because of sudden onset of seizure during sleep. Each time he recovered within a few hours without any medication. Nocturnal polysomnographic recording revealed severe obstructive sleep apnea syndrome (OSAS, AHI 52.4/Hr). Nasal continuous positive airway pressure (n-CPAP) therapy was performed with 10cmH2O of pressure. His symptoms of severe daytime sleepiness and seizure were diminished. CPAP was decreased from 10cmH2O to 6 cmH2O later, because the patient complained with its high pressure. He then felt daytime sleepiness and suffered seizures during sleep again, and was re-admitted to our hospital. Chest roentgenogram taken at this admission showed remarkable pulmonary edema. We found that the pulmonary edema was recognized every time on his chest roentgenogram taken when he complained seizure. In addition, subsequesnt roentgenograms also showed that the pulmonary edema was diminished soon. On the other hand, his AHI was high (24.7/hr) even when he was under 6cmH2O of n-CPAP. We concluded that incompletely treated OSAS might lead not only to pulmonary edema, but also to seizures in this patient.     

Platelet activation in obstructive sleep apnea syndrome]

The incidences of cardiovascular and cerebrovascular diseases are reportedly higher in patients with obstructive sleep apnea (OSA) than in OSA-free subjects, though the mechanism remains unknown. Recently, the contribution of activated platelets to a number of pathological conditions such as stroke or ischemic heart disease has been suggested. We hypothesized that the expression of activated platelet markers resulting from OSA might be higher than in healthy subjects. By flow cytometry using monoclonal antibodies, we measured two such markers, PAC-1 and CD 62 P, in OSA patients and healthy subjects. Twelve healthy men (age, 52.7 +/- 12.8 y/o; and body mass index (BMI), 22.2 +/- 16.1 kg/m2; mean +/- S.D.) and 20 male patients with OSA (age, 50 +/- 7.96 y/o; BMI, 28.1 +/- 3.3 kg/m2; apnea hypopnea index (AHI), 38.2 +/- 21.2 times/hr; and lowest SpO2, 75.6 +/- 11.3%) were enrolled in this study. PAC-1 expression was significantly higher in OSA patients (65.1 +/- 17.8%) than in healthy subjects (16.8 +/- 7.4%), as was CD 62 P expression (8.5 +/- 8.8% vs. 0.88 +/- 0.57%). The increase in PAC-1 expression was correlated with AHI and the arousal index. These findings suggest that activated platelet markers could be good indicators for untreated OSA.     

阻塞性睡眠呼吸暂停综合征患者的血氧饱和度和肺功能变化

目的分析阻塞性睡眠呼吸暂停综合征（OSAHS）患者及OSAHS合并慢性阻塞性肺病（COPD）亦称重叠综合征患者的饱和度和肺功能变化特点。方法对经过多导睡眠图（PSG）、肺功能仪检查的60例患者进行回顾性分析。结果OSAHS患者与重叠综合征患者的呼吸暂停低通气指数（AHI）、最长呼吸暂停时间（LAT）、最低脉氧饱和度（LSaO2）、平均脉氧饱和度（MSaO2）与COPD患者均有明显差异;而且重叠综合征患者肺通气功能受损严重。结论重叠综合征患者的姐氧饱和度下降和肺通气功能受损比COPD患者显著,对夜间缺氧明显的COPD患者及时检测多导睡眠图,便于及早发现老年人OSAHS的发生。     

阻塞性睡眠呼吸暂停对肺循环的影响

阻塞性睡眠呼吸暂停（OSA）是一种常见病和多发病,其对心血管系统包括肺循环和体循环有着重要影响。OSA可引起急性肺动脉高压,主要是由于低氧性肺血管收缩以及机械效应和觉醒状态下的反射性血管收缩,在一些OSA患者中发现了一些长期的改变,这可能是由于大多数患者经常因相关的肺疾病导致日间低氧血症,从而发展成持续的肺动脉高压的结果,但也有证据表明OSA是引起日间肺动脉高压的独立危险因素。现将OSA对肺循环与右心室的已知影响,包括急性和慢性影响作一综述。     

CT studies on obstructive sleep apnea syndrome]

To ascertain whether there are structural and functional changes in the upper airway of obstructive sleep apnea syndrome (OSAS) pts. We studied 33 pts of OSAS with positive polysomnographic tests, 14 pts of non-apnea snore with negative polysomnographic tests, and 18 normal subject by using CT scanner (Somatom Dr 3). The results are as followings 1. There were narrowing region in the upper airway in OSAS pts and the non-apnea snore pts. Most of the narrowings were located at the level of oropharynx, which was correspondent to the level of the soft palate and the uvula. The length of the soft palate and the pre-spinal soft tissue thickness of two groups of pts were larger than non-snore individual. 2. The pharyngeal compliance was significantly higher in OSAS pts than in non-apnea snore pts. 3. There was no localised deposition of fat tissue surrounding the lumen of upper airway. 4. CT scanning is the non-invasive and more useful procedure for the diagnosis of OSAS and also would help to select the pts for surgery.     

慢性阻塞性肺病合并睡眠呼吸暂停综合征的研究

为研究慢性阻塞性肺病（COPD）合并阻塞性睡眠呼吸暂停综合征（OSAS）的临床特点，对50例COPD患者据其第1次睡眠呼吸监测结果分为COPD组和COPD合并OSAS组，两组各选10例在吸氧下行第2次睡眠呼吸监测，其中COPD合并OSAS组在持续正压通气（CPAP）和双水平正压通气（BiPAP）治疗下行第3、4次睡眠呼吸监测，10例COPD合并OSAS患者在吸氧同时加用CPAP和BiPAP治疗下行第5、6次睡眠呼吸监测。结果显示，在COPD合并OSAS发病率为24％。COPD合并OSAS患者体重大，夜间打鼾，缺氧明显，呼吸衰竭和心力衰竭发生率高，睡眠潜伏期短（SLT），呼吸紊乱指数（RDI）大。睡眠时氧可使两组患者RDI增大。COPD合并OSAS组50％耐受CPAP通气治疗，皆能耐受BiPAP治疗，吸氧同时加用机械通气可取得更理想疗效。提示COPD合并OSAS患者病情危重，对其氧疗的同时给予CPAP和BiPAP通气是抢救成功的关键。     

Relationship between pulmonary functions and sleep respiratory abnormalities in obstructive sleep apnea syndrome

Pulmonary function tests were performed in 18 cases of obstructive sleep apnea in supine and sitting positions and the relationship between pulmonary function and polysomnographic data was analyzed. %FRC and PaO2 were reduced in the supine position compared with those in the sitting position. It was suggested that the reduction of PaO2 was mainly caused by the elevation of CC/FRC ratio in supine position. The relationship between pulmonary function data and polysomnographic data were analyzed, and an inverse relationship between %FRC in sitting position and desaturation was observed and also a positive relationship between PaO2 in the supine position mean-nadir SO2 was found. Saw-tooth sign and VE50/VI50 greater than 1 on flow-volume curves were not related to the apnea index and desaturation index. These results indicate that the F-V curve is not useful for the diagnosis of OSA.     

Overlap syndrome involving obstructive sleep apnea syndrome associated with chronic obstructive pulmonary disease

We reported a case of overlap syndrome involving severe obstructive sleep apnea syndrome (OSAS) associated with chronic obstructive lung disease (COPD). This patient was a 52-year-old heavy smoking man, who had suffered from snoring and apnea for five years, and was admitted to our hospital because of worsening dyspnea. His BMI was 25 Kg/M2, His jaw was very small and he had a narrow upper airway. Chest X-ray showed hyperlucency throughout both lung fields with a markedly dilatation pulmonary arteries. His PaO2 was 62Torr, PaCO2 was 47Torr, FEV(1.0%) was 59%, mean pulmonary artery pressure was 27 mmHg, PSG showed that AHI was 70, were most pronounced during rapid eye movement sleep. He was given a diagnosis of overlap syndrome of OSAS associated with COPD. Generally, Overlap syndrome was believed that chronic bronchitis type (blue bloater) was more frequent than emphysema type. This case was a very rare case, with no obesity, moderate COPD, associated with pulmonary hypertension and hypercapnea, and then to be severe OSAS. However we should be more careful about the OSAS associated with overlap syndrome of the Japanese patients, because to be one factor of exacerbation of respiratory failure.     

Daytime pulmonary hypertension in patients with obstructive sleep apnea syndrome

The frequency of daytime pulmonary hypertension (PH) in patients with obstructive sleep apnea syndrome (OSAS) has not been well established and its mechanisms are still under debate. We have thus performed right heart catheterization, in addition to standard spirography and arterial blood gas measurements, in a series of 46 consecutive patients in whom OSAS was firmly diagnosed by whole-night polysomnography. Only 9 of the 46 patients (20%) had PH defined by a mean resting pulmonary arterial pressure (Ppa) greater than or equal to 20 mm Hg. Among the patients without resting PH, 14 had exercising PH (defined by a Ppa greater than 30 mm Hg during 40-watt, steady-state exercise). Patients with resting PH differed from the others by a lower daytime PaO2 (60.8 +/- 7.6 versus 76.2 +/- 9.4 mm Hg; p less than 0.001), a higher daytime PaCO2 (44.6 +/- 4.2 versus 38.0 +/- 4.0 mm Hg; p less than 0.001), and lower VC and FEV1 (p less than 0.001). There was no difference between the 2 groups with regard to apnea index (62 +/- 34 versus 65 +/- 40) or the lowest sleep SaO2 (59 +/- 21 versus 66 +/- 18%) or the time spent in apnea. For the group as a whole, there was a good correlation between Ppa and daytime PaO2 (r = -0.61; p less than 0.001), PaCO2 (r = 0.55; p less than 0.001), and FEV1 (r = -0.52; p less than 0.001), but there was no significant correlation between Ppa and the apnea index, the lowest sleep SaO2, or the time spent in apnea.(ABSTRACT TRUNCATED AT 250 WORDS)     

合并阻塞性睡眠呼吸暂停低通气综合征对慢性阻塞性肺疾病患者心功能的影响

目的分析单纯慢性阻塞性肺疾病(简称慢阻肺)患者与慢阻肺合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特征,研究合并OSAHS对慢阻肺患者心功能的影响。方法本研究回顾性纳入2016年9月至2018年10月就诊于北京大学第三医院呼吸与危重症医学科门诊的稳定期慢阻肺患者126例,其中男112例,女14例,年龄48~89岁,中位年龄67岁。以呼吸暂停低通气指数(AHI)5次/h为界值,分为单纯慢阻肺组(31例)和慢阻肺合并OSAHS组(95例),比较患者的人口学特征、呼吸道症状、肺功能、心血管事件发生率和反映患者的患者心功能的超声心动图E/e′比率、左心房前后径(LAD)及左心室射血分数(LVEF)等指标,采用独立样本t检验、卡方检验等对数据进行统计学分析。结果单纯慢阻肺患者与慢阻肺合并OSAHS患者的人口学特征、呼吸道症状、肺功能差异均无统计学意义,各项夜间血氧饱和度水平指标差异均有统计学意义(均P<0.05),两组患者左心室质量指数(LVMI)差异有统计学意义(P=0.047),而心血管事件发生率差异无统计学意义。AHI≥30次/h的合并严重OSAHS的患者与AHI<30次/h的非严重OSAHS的患者相比,超声心动图指标E/e′(P=0.013)、LAD(P=0.006)、LVMI(P=0.051)、LVEF(P=0.030)差异均有统计学意义,冠心病及充血性心力衰竭病史差异有统计学意义(P=0.025,P<0.001)。按轻中重度对慢阻肺合并OSAHS患者严重程度进行分组后,E/e′及LAD与严重程度明显相关(P=0.045,P=0.011)。夜间血氧饱和度水平方面,夜间平均血氧饱和度和E/e′、LAD、LVMI均有显著相关性(r=-0.195,P=0.033;r=-0.197,P=0.030;r=-0.195,P=0.044);血氧饱和度≤90%的比例与LAD有显著相关性(r=0.209,P=0.021)。多元线性回归模型中,AHI每增加一个单位时E/e′平均增加0.070,氧减指数每增加一个单位时E/e′平均增加0.084。结论慢阻肺合并重度OSAHS的患者与慢阻肺合并非重度OSAHS患者相比,左心舒张功能显著降低且发生充血性心力衰竭和冠心病的风险显著增加,且慢阻肺合并OSAHS的严重程度与左心舒张功能受限的严重程度相关,AHI越高、氧减指数越高,左心舒张功能受限及结构改变越严重。     

合并阻塞性睡眠呼吸暂停低通气综合征对慢性阻塞性肺疾病患者心功能的影响

目的分析单纯慢性阻塞性肺疾病(简称慢阻肺)患者与慢阻肺合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特征,研究合并OSAHS对慢阻肺患者心功能的影响。方法本研究回顾性纳入2016年9月至2018年10月就诊于北京大学第三医院呼吸与危重症医学科门诊的稳定期慢阻肺患者126例,其中男112例,女14例,年龄48~89岁,中位年龄67岁。以呼吸暂停低通气指数(AHI)5次/h为界值,分为单纯慢阻肺组(31例)和慢阻肺合并OSAHS组(95例),比较患者的人口学特征、呼吸道症状、肺功能、心血管事件发生率和反映患者的患者心功能的超声心动图E/e′比率、左心房前后径(LAD)及左心室射血分数(LVEF)等指标,采用独立样本t检验、卡方检验等对数据进行统计学分析。结果单纯慢阻肺患者与慢阻肺合并OSAHS患者的人口学特征、呼吸道症状、肺功能差异均无统计学意义,各项夜间血氧饱和度水平指标差异均有统计学意义(均P<0.05),两组患者左心室质量指数(LVMI)差异有统计学意义(P=0.047),而心血管事件发生率差异无统计学意义。AHI≥30次/h的合并严重OSAHS的患者与AHI<30次/h的非严重OSAHS的患者相比,超声心动图指标E/e′(P=0.013)、LAD(P=0.006)、LVMI(P=0.051)、LVEF(P=0.030)差异均有统计学意义,冠心病及充血性心力衰竭病史差异有统计学意义(P=0.025,P<0.001)。按轻中重度对慢阻肺合并OSAHS患者严重程度进行分组后,E/e′及LAD与严重程度明显相关(P=0.045,P=0.011)。夜间血氧饱和度水平方面,夜间平均血氧饱和度和E/e′、LAD、LVMI均有显著相关性(r=-0.195,P=0.033;r=-0.197,P=0.030;r=-0.195,P=0.044);血氧饱和度≤90%的比例与LAD有显著相关性(r=0.209,P=0.021)。多元线性回归模型中,AHI每增加一个单位时E/e′平均增加0.070,氧减指数每增加一个单位时E/e′平均增加0.084。结论慢阻肺合并重度OSAHS的患者与慢阻肺合并非重度OSAHS患者相比,左心舒张功能显著降低且发生充血性心力衰竭和冠心病的风险显著增加,且慢阻肺合并OSAHS的严重程度与左心舒张功能受限的严重程度相关,AHI越高、氧减指数越高,左心舒张功能受限及结构改变越严重。     

慢性阻塞性肺疾病和阻塞性睡眠呼吸暂停低通气综合征重叠综合征患者免疫功能的变化

目的探讨慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)[重叠综合征(OS)]患者免疫功能特点。方法选取78例COPD稳定期(COPD组)、70例OSAHS(OSAHS组)、58例OS(OS组)患者和32名健康者(健康组)为对象,采用流式细胞仪、免疫散射比浊法分别对其细胞免疫(CD4~+、CD8~+、CD4~+/CD8~+)和体液免疫(Ig A、Ig G、Ig M)水平进行检测;其中30例OS患者在进行双水平气道正压(BiPAP)通气治疗3个月后对上述指标进行复测。结果与健康组相比,COPD、OSAHS和OS患者CD4~+、CD4~+/CD8~+、Ig A、Ig G、Ig M的水平下降(t=2.851~12.897,P0.05);与COPD、OSAHS组相比,OS组患者上述免疫指标更低(t=2.756~3.075,P0.05);30例OS患者在Bi PAP治疗后上述免疫指标上升,差异具有统计学意义(t=2.367~3.758,P0.05)。结论 COPD合并OSAHS的OS患者免疫功能更为低下,在临床上应引起足够重视,Bi PAP通气治疗有助于改善其免疫功能。     

肺功能联合睡眠呼吸暂停临床评分对慢性阻塞性肺疾病重叠阻塞性睡眠呼吸暂停患者的初筛价值

目的 探讨第1秒用力呼气容积占预计值百分比(FEV₁%pred)结合睡眠呼吸暂停临床评分(SACS)对慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)患者的初筛价值。方法 选取2020年1月至12月于航天中心医院呼吸与危重症医学科住院检查确诊为COPD的299例患者为研究对象,所有患者均完成肺功能FEV₁%pred检查以及SACS,行整夜多导睡眠图(PSG)监测。根据睡眠呼吸暂停低通气指数(AHI)将患者分为单纯COPD组和COPD合并OSA(重叠综合征,OVS)组。采用SPSS 23.0软件进行统计分析。根据数据类型,组间比较分别采用独立样本t检验或χ²检验。采用Pearson′s相关系数分析FEV₁%pred、SACS与AHI的相关性。采用受试者工作特征(ROC)曲线分析FEV₁%pred结合SACS预测COPD患者OVS的价值。 结果 OVS组FEV₁%pred [(53.4±15.1)和(43.6±13.9)%;P<0.05]及SACS[(19.1±3.9)和(7.3±2.1)分;P<0.05]显著高于单纯COPD组。相关性分析显示,AHI与FEV₁%pred(r=0.631,P<0.05)及SACS(r=0.689,P<0.05)呈正相关。ROC曲线显示,FEV₁%pred诊断OVS的最佳截断点为48.3%,灵敏度和特异度分别为81.3%和75.4%;SACS诊断OVS的最佳截断值为16,灵敏度和特异度分别为83.2%和79.3%;将FEV₁%pred≥48.3%和SACS≥16分作为联合指标诊断OVS的曲线下面积为0.812(95%CI 0.781～0.903),灵敏度和特异度分别为85.2%和79.5%。 结论 FEV₁%pred联合SACS评分对筛查COPD患者OVS具有良好的预测价值。     

不同严重程度的阻塞性睡眠呼吸暂停低通气综合征患者的肺功能分析

目的研究不同严重程度的阻塞性睡眠呼吸暂停低通气综合征患者的肺功能变化。方法选取于我院因打鼾、白天嗜睡、夜间呼吸暂停就诊的患者,共184例,所有人均行肺功能、多导睡眠图(PSG)检查,根据呼吸暂停低通气指数(AHI)分为4组:对照组49例(AHI<5)、轻度组37例(5≤AHI<15)、中度组43例(15≤AHI<30)、重度组55例(AHI≥30)。分析各组肺活量(VC)实/预、补呼气量(ERV)、功能残气量(FRC)、第1秒呼气量(FEV 1)实/预、1秒率(FEV 1/FVC%)、最大呼气中期流速(MMEF)实/预%、50%肺活量流速(FEF 50%)实/预%、75%肺活量流速(FEF 75%)实/预%、肺总量(TLC)实/预、一氧化碳弥散量(TLCO)实/预%、最大自主通气量(MVV)、残气量/肺总量(RV/TLC)等指标。结果重度组MMEF实/预%、FEF 50%实/预%、FEF 75%实/预%、ERV、FRC明显低于中度组,中度组上述指标较轻度组降低,轻度组低于对照组,差异均有显著的统计学意义(P<0.05),而VC实/预%、FEV 1实/预%、FEV 1/FVC%、TLC实/预%、DLCO实/预%、RV/TLC%、MVV各组之间差异无统计学意义(P>0.05);此外MMEF实/预%、FEF 50%实/预%、FEF 75%实/预%与AHI、LAT呈负相关,与LSaO 2呈正相关;ERV、FRC与BMI呈负相关。结论OSAHS患者存在小气道功能损害,且其受损程度与夜间睡眠紊乱程度呈正相关。     

Manifestation of pulmonary hypertension during REM sleep in obstructive sleep apnea syndrome.

The effect of sleep stage change on pulmonary circulation has not been well documented in patients with obstructive sleep apnea syndrome (OSAS). We investigated whether or not stage-specific change can affect pulmonary artery pressure (Ppa) in patients with OSAS. Thirty-one patients with OSAS underwent right cardiac catheterization in the daytime and the following night, including 19 patients in whom Ppa could be measured throughout non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. Ten of the 19 patients had daytime pulmonary hypertension (PH) defined by a mean Ppa (Ppa) >/= 20 mm Hg. Then we analyzed Ppa response to hypoxia spontaneously occurring during the period of sleep apnea. The slopes of the regression lines between arterial oxygen saturation measured by pulse oximeter (SpO2) and Ppa curves were almost the same in both NREM and REM patient groups with or without daytime PH, whereas the response curve was significantly shifted upward in REM compared with NREM patients with daytime PH. Furthermore, Ppa was elevated more markedly in association with REM burst, phasic REM, compared with tonic REM. We conclude that vascular tone of pulmonary artery could be elevated in association with REM sleep which is independent of the degree of hypoxia, and that this state-specific change is manifested in patients with daytime PH.     

阻塞性睡眠呼吸暂停综合征与慢性阻塞性肺疾病的相关分析

目的观察阻塞性睡眠呼吸暂停综合征（OSAS）与慢性阻塞性肺疾病（COPD）是否具有相关性。对50例OSAS患者依是否伴发COPD分为单纯OSAS组和重叠综合征组,分别对其肺功能和睡眠呼吸多导分析资料进性分析。50例中30例为重叠综合征,其夜间与睡眠有关的低氧血症较单纯OSAS患者更为明显。     

Overlap syndrome: obstructive sleep apnea in patients with chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) and sleep apnea-hypopnea syndrome (SAHS) are both common diseases affecting respectively 10 and 5% of the adult population over 40 years of age, and their coexistence, which is denominated overlap syndrome, can be expected to occur in about 0.5% of this population. A recent epidemiologic study has shown that the prevalence of SAHS is not higher in COPD than in the general population, and that the coexistence of the two conditions is due to chance and not through a pathophysiologic linkage between these two diseases. Patients with overlap have a more important sleep-related O(2) desaturation than do patients with COPD with the same degree of bronchial obstruction. They have an increased risk of developing hypercapnic respiratory insufficiency and pulmonary hypertension when compared with patients with SAHS alone and with patients with "usual" COPD. In patients with overlap, hypoxemia, hypercapnia, and pulmonary hypertension can be observed in the presence of mild to moderate bronchial obstruction, which is different from "usual" COPD. Therapy of the overlap syndrome consists of nasal continuous positive airway pressure or nocturnal noninvasive ventilation (NIV), with or without associated nocturnal O(2). Patients who are markedly hypoxemic during daytime (Pa(O(2)) < 55-60 mm Hg) should be given conventional long-term O(2) therapy in addition to nocturnal ventilation.     

OSAHS对血管内皮功能变化的影响

目的探讨OSAHS对血管内皮功能变化的影响。方法选取OSAHS患者80例(OSAHS组),分为轻度15例,中度41例,重度24例,体检肥胖者30例(对照组),检测血清ET-1、NO、ADM水平。结果 OSAHS组NO低于对照组(P0.05),ET-1、ADM高于对照组(P0.05),中度、重度患者NO高于轻度(P0.05),重度高于中度(P0.05),ET-1、ADM中度及重度低于轻度(P0.05),重度低于中度(P0.05);治疗后AHI、ET-1、ADM下降(P0.05),SaO2、NO升高(P0.05);OSAHS患者NO与AHI存在负相关(P0.05),ET-1、ADM与AHI存在正相关(P0.05)。结论 OSAHS中重度患者明显存在血管内皮功能受损。     

睡眠呼吸暂停低通气综合征问卷对阻塞性睡眠呼吸暂停综合征诊断价值

目的 评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的流行病学调查表筛查价值.方法 疑似OSAHS的987例患者为研究对象,按照中华医学会呼吸病学分会睡眠学组睡眠呼吸暂停低通气综合征流行病学调查表进行问卷并行多导睡眠监测.将此问卷表进行量化评分,用克隆巴赫信度系数(α系数)进行信度计算,将各相关因素做方差分析及x2检验,筛选出有统计学意义的因素最后做Logistic回归分析.以鼾声中度以上的打鼾及体质量指数≥25 kg/m2为高危,反之为低危,进行敏感性,特异性,假阳性,假阴性,阳性似然比,阴性似然比,阳性预测值等.结果 疑似OSAHS患者987例,其中男800例(81.05％),女187例(18.95％),年龄18～80岁,平均(47±12)岁,平均体质量指数(29±5) kg/m2.＞60岁者156例(15.81％),≤60岁者831例(84.19％).克隆巴赫信度系数(Cronbach'salpha)是0.803,假阳性者20,假阴性者142,真阳性者742,真阴性者83,问卷的敏感性是83.94％,特异性是80.58％,假阳性率19.42％,假阴性率16.06％,阳性似然比4.32,阴性似然比0.20,阳性预测值0.97,阴性预测值0.37,正确率83.59％.结论 该睡眠调查表对OSAHS筛查具有一定意义,可用于临床OSAHS的初筛,尤其适合在社区和基层医院中推广使用.