行为认知治疗对阻塞性睡眠呼吸暂停导致低通气综合征的患儿的影响

目的 探讨阻塞性睡眠呼吸暂停导致的低通气综合征患儿应用行为认知治疗后的效果.方法 将我院91例阻塞性睡眠呼吸暂停导致的低通气综合征患儿采用随机数字表法进行分组,对照组45例患儿给予糠酸莫米松鼻喷雾喷鼻联合孟鲁司特钠口服治疗,观察组46例患者在对照组基础上增加认知行为治疗,对比两组患儿干预后睡眠过程中暂停次数、动脉血氧饱...     

阻塞性睡眠呼吸暂停低通气综合征伴发肥胖低通气综合征23例诊治分析

本文研究安阳地区医院23例肥胖低通气综合征(OHS)合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者资料,报告如下。1资料与方法1.1研究对象2007-2011年我院23例OHS合并OS-AHS患者,男21例,女2例,年龄38～68岁,平均45.6岁。1.2方法经整夜多导睡眠图(PSG)检查,符合OSAHS诊断标准。OHS诊断标准:BMI≥30kg/m2,存在慢性肺泡     

阻塞性睡眠呼吸暂停低通气综合征对急性脑梗死患者认知功能的影响

目的探讨阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)对急性脑梗死患者认知功能的影响,为血管性认知障碍的早期防治提供依据。方法对经头颅CT或MRI证实的急性脑梗死患者(41例,男21例,女20例)均进行多导睡眠图(polysomnogram,PSG)、简易智能筛查(mini-mental state examination,MMSE)、画钟试验(clock drawing task,CDT)、词语流畅试验(verbal fluency test,VFT)、听觉事件相关电位(P300)检测。结果 41例患者完成所有检查。MMSE评分27分者27例(65.85%),CDT评分4分者19例(46.34%),VFT评分15分者16例(39.02%)。依PSG检查结果分为OSAHS组(21例),非OSAHS组(20例)。OSAHS组MMSE、CDT分值低于非OSAHS组,两组比较无统计学差异(P0.05),亚组分析显示中-重度OSAHS组MMSE、CDT得分为23.67±5.12,2.67±1.53,非OSAHS组为24.85±3.15,3.1±1.2,两组比较有统计学差异(P0.05)。P300检查显示与非OSAHS组比较OSAHS组FZ、CZ、PZ潜伏期明显延长,FZ、CZ潜伏期比较有统计学差异(P0.05),中重度OSAHS组较非OSAHS组PZ潜伏期显著延长(P0.005)。各组P300的波幅无统计学差异(P0.05)。结论 OSAHS可加重急性脑梗死者的认知功能障碍,且与其严重程度相关。P300检查较MMSE、CDT更敏感。     

阻塞性睡眠呼吸暂停低通气综合征及脑卒中与认知功能障碍的关系

阻塞性睡眠呼吸暂停低通气综合征（OSAHS）是脑卒中的危险因素,脑卒中患者合并阻塞性睡眠呼吸暂停在流行病学上也远远高于普通人群的发病率.OSAHS及脑卒中都可以发生认知功能障碍,两者并存有可能加剧患者认知功能障碍程度及影响恢复,研究和了解OSAHS对卒中后认知功能的影响,对卒中相关认知障碍的防治有着重要的意义.     

急性脑梗死患者的阻塞性睡眠呼吸暂停低通气综合征临床分析

目的 本研究初步探讨了急性脑梗死合并阻塞性睡眠呼吸暂停低通气综合征的临床特点.方法 评价19例连续收住的首次、非昏迷急性脑梗死患者和同期10例健康成人的年龄、性别、体重指数(BMI)、睡眠打鼾史、高血压病史、吸烟史、饮酒史、动脉血压,研究组还记录入院时和7d时斯堪的纳维亚卒中量表得分(SSS),使用多导睡眠监测系统记录睡眠过程中的多项生理事件,评价AHI和最低动脉血氧饱和度(SaO2).结果 急性脑梗死后74%患者有阻塞性或混合性睡眠呼吸暂停,63%的急性脑梗死患者出现了具有临床意义的睡眠呼吸暂停,AHI与患者年龄、BMI、最低SaO2、睡眠打鼾史、吸烟史、高血压、SSS有关,呼吸事件主要为阻塞性或混合性睡眠呼吸暂停,中枢性睡眠呼吸暂停在所有呼吸事件中约占8%.既往有心脏病史的患者甚至会出现Cheyne-Stokes呼吸.结论 应重视评价急性脑梗死患者OSAHS发生的可能性,对于病情重、存在多种脑血管病危险因素的患者更应作为常规评价的一部分.     

中年阻塞性睡眠呼吸暂停低通气综合征对认知功能及记忆的影响

目的探讨中年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对认知功能及记忆的影响。方法选择年龄45～59岁的中年OSAHS患者80例为OSAHS组,另入选60例同期健康体检者为正常对照组。采用简易智能状态检查量表(MMSE)和临床记忆量表对受试者的认知功能及记忆进行评分,并比较2组间评分的差异。结果 (1)OSAHS组在MMSE量表中即刻记忆评分(2.88±0.36)、注意力和计算力评分(3.18±0.41)、短时记忆评分(1.82±0.34)和MMSE总量表评分评分(1.82±0.34)各项得分低于对照组,差异有统计学意义(P<0.05);(2)OSAHS组在临床记忆量表中指向记忆评分(11.91±5.14)、联想学习评分(13.52±4.18)、图像自由回忆评分(11.28±4.12)、无意义图形再认评分(15.27±5.06)、人像特点回忆评分(12.92±6.28)、总分(67.34±16.03)和记忆商评分(MQ)(76.32±12.53)各项等值量表分得分明显低于对照组,差异有统计学意义(P<0.05)。结论中年OSAHS患者存在明显的认知功能及记忆损害。     

阻塞性睡眠呼吸暂停低通气综合征与高血压之间关系的研究进展

【摘要】 阻塞性睡眠呼吸暂停低通气综合征与高血压关系密切,可能是某些继发性高血压的主要病因之一,对合并阻塞性睡眠呼吸暂停低通气综合征的高血压患者采取综合性治疗对控制高血压及心脑血管病可能有益处。     

老年阻塞性睡眠呼吸暂停低通气综合征的临床特点与护理

本文通过对62例60岁以上老人阻塞性睡眠呼吸暂停低通气综合征的临床观察与护理,总结了老年阻塞性睡眠呼吸暂停低通气综合征临床特点与护理措施如下.     

血浆同型半胱氨酸在阻塞性睡眠呼吸暂停低通气综合征和脑梗死关系中的作用

目的探讨血浆同型半胱氨酸在阻塞性睡眠呼吸暂停低通气综合征和脑梗死关系中的作用。方法采用荧光偏振免疫分析检测法测定38例阻塞性睡眠呼吸暂停低通气综合征（Obstructivesleep Apnea-Hyperpnoea Sydrome,OSAHS）、40脑梗死、39例OSAHS合并脑梗死患者和42例正常对照者血浆中同型半胱氨酸水平。结果OSAHS、脑梗死和OSAHS合并脑梗死组的血浆Hcy水平明显高于正常对照组（P〈0．05）;OSAHS合并脑梗死组血浆Hcy高于脑梗死组和OSAHS组（P分别〈0．01和0．05）。结论OSAHS患者血浆Hcy水平增高可能是导致其脑梗死发生的原因之一。     

阻塞性睡眠呼吸暂停低通气综合征与醒后卒中之间关系的研究进展

醒后卒中（wake-up stroke，WUS）患者通常由于发病时间不确切而延误包括静脉溶栓在内 的超早期治疗，并且WUS与清醒时发病的缺血性卒中相比在危险因素及发病机制等方面尚存在差异。 因此，了解WUS的危险因素并且早期干预具有重要意义。目前，关于WUS危险因素的研究表明OSAHS是 WUS的重要危险因素之一，但是OSAHS引起WUS的机制尚未阐明。本文就目前OSAHS与WUS之间关系的 研究进展进行综述。     

阻塞性睡眠呼吸暂停与认知障碍的相关研究进展

阻塞性睡眠呼吸暂停（OSA）可对患者生理、心理功能及生活质量造成严重的影响，OSA 致 认知障碍已成为研究热点。目前，OSA 导致认知障碍的发病机制及相关治疗尚不完全明确，现对相关 机制和治疗进行综述，以提高相关认识。     

Detection of cognitive impairment in patients with obstructive sleep apnea hypopnea syndrome using mismatch negativity

In this experiment,97 patients with obstructive sleep apnea hypopnea syndrome were divided into three groups(mild,moderate,severe) according to minimum oxygen saturation,and 35 healthy subjects were examined as controls.Cognitive function was determined using the mismatch negativity paradigm and the Montreal Cognitive Assessment.The results revealed that as the disease worsened,the mismatch negativity latency was gradually extended,and the amplitude gradually declined in patients with obstructive sleep apnea hypopnea syndrome.Importantly,mismatch negativity latency in severe patients with a persistent time of minimum oxygen saturation < 60 seconds was significantly shorter than that with a persistent time of minimum oxygen saturation > 60 seconds.Correlation analysis revealed a negative correlation between minimum oxygen saturation latency and Montreal Cognitive Assessment scores.These findings indicate that intermittent night-time hypoxemia affects mismatch negativity waveforms and Montreal Cognitive Assessment scores.As indicators for detecting the cognitive functional status of obstructive sleep apnea hypopnea syndrome patients,the sensitivity of mismatch negativity is 82.93%,the specificity is 73.33%,the accuracy rate is 81.52%,the positive predictive value is 85.00%,the negative predictive value is 70.21%,the positive likelihood ratio is 3,and the negative likelihood ratio is 0.23.These results indicate that mismatch negativity can be used as an effective tool for diagnosis of cognitive dysfunction in obstructive sleep apnea hypopnea syndrome patients.     

脑梗死伴阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构及认知功能分析

目的 探讨脑梗死伴阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者睡眠结构的特点及与认知功能的相关性.方法 选择2009年12月至2011年3月在天津医科大学总医院神经内科及呼吸睡眠监测室就诊的打鼾患者,行多导睡眠监测,筛选出60例患者,分为合并组(脑梗死合并OSAHS)20例,OSAHS组(单纯OSAHS)20例及对照组(无脑梗死及OSAHS)20例,均完善相关检查及进行认知功能的评分[ MMSE和蒙特利尔认知评估量表(MoCA)].结果 睡眠结构比较:合并组及OSAHS组与对照组比较,患者醒觉时间、非快速眼球运动(NREM)期、NREM 1+2期延长,NREM3+4期及快速眼球运动(REM)期缩短.合并组与OSAHS组比较,NREM期及NREM 1期延长,NREM 3+4及REM期缩短.认知功能与呼吸紊乱及低氧相关指数相关性分析:OSAHS组患者MMSE和MoCA评分与呼吸暂停低通气指数(AHI)、氧减指数(ODI)呈线性负相关(MMSE r=-0.450、-0.671,MoCA r=-0.486、-0.494,均P＜0.05),与夜间平均血氧及夜间最低血氧呈线性正相关(MMSE r=0.477、0.485,MoCA r=0.507、0.482,均P＜0.05).合并组患者MoCA评分与ODI、微觉醒指数呈线性负相关(r=-0.463、-0.480,均P＜0.05),MMSE评分与呼吸紊乱及低氧相关指数相关无统计学意义.认知功能与睡眠分期相关性分析:OSAHS组患者MMSE及MoCA评分均与NREM 3 +4期呈线性正相关(r=0.521、0.474,均P＜0.05),MMSE评分与NREM 1+2期呈线性负相关(r=-0.458,P＜0.05).合并组患者MoCA评分与REM期呈线性正相关(r=0.472,P＜0.05),MMSE评分与睡眠分期相关无统计学意义.结论 OSAHS患者睡眠结构紊乱,特点为觉醒时间与浅睡眠延长,深睡眠与REM期缩短,脑梗死伴OSAHS睡眠结构紊乱更严重,合并脑梗死使OSAHS浅睡眠1期延长更明显.OSAHS患者夜间血氧越低,呼吸紊乱指数越高,微觉醒次数越多,浅睡眠时间越长,深睡眠及REM期睡眠越短,认知功能受损越严重,但认知功能损害与低氧的相关性比睡眠结构紊乱的相关性明显.脑梗死伴OSAHS患者MoCA评分与缺氧程度及睡眠结构的一些指标相关性明显,MoCA在轻中度血管性认知功能障碍筛选中的敏感性高于MMSE.     

Three components of obstructive sleep apnea/hypopnea syndrome

The aims of this study were to calculate the apnea-hypopnea index (AHI), which represented as the number of apnea-hypopnea occurrences per hour, the 4% oxygen desaturation index (ODI4) and the breathing-related arousal index (B-ArI) in polysomnographic studies of obstructive sleep apnea/hypopnea syndrome (OSAHS) patients and to investigate whether there was any relationship between each pair of scoring schemes. Thirty-four cases of OSAHS were studied. Total OSAHS patients were subdivided into those with a high AHI (> 25), and those with a low AHI (< 25). The correlation between each pair of scoring schemes for OSAHS with a high AHI showed high value. The correlation between AHI and ODI4 for OSAHS with a low AHI was 0.18 and that between AHI and B-ArI showed a weak correlation of 0.59, while that between ODI4 and B-ArI was only -0.078. Our results mean that oxygen desaturation and arousal occur separately in mild or moderate OSAHS patients, even though they are diagnosed with the same level of OSAHS by means of AHI. Breathing-related arousal without oxygen desaturation often occurs in mild or moderate OSAHS patients. We previously reported that AHI does not accurately reflect the severity of the increase in negativity of esophageal pressure manifested as respiratory efforts. We consider that the comprehension and assessment of OSAHS can be improved by the systematic differentiations among the three components: oxygen desaturation, arousals and respiratory efforts.     

阻塞性睡眠呼吸暂停低通气综合征患者的心理特征

<正>阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea Hypopea Syndrome,OSAHS)是一种以睡眠中反复出现的上气道狭窄或阻塞导致的频繁低通气和/或呼吸暂停为特征的睡眠紊乱,常伴有明显的鼾声。呼吸暂停引起血氧饱和度下降,交感神经活性增强,心率和血压波动,进而出现皮层微觉醒和睡眠片断化[1]。由于夜间睡眠质量下降,患者常表现明显的嗜睡、疲劳感、注意力不集中和记忆力下     

Driving impairment in patients with obstructive sleep apnea syndrome

Drivers with obstructive sleep apnea syndrome (OSAS) have an increased risk of motor vehicle crashes. Unfortunately, neither clinical nor polysomnographic features allow clinicians to reliably identify high-risk drivers. One potential means of identifying these drivers is with the use of driving simulators. Several investigators have shown that OSAS patients perform worse than healthy control drivers and results from our studies have demonstrated declines in driving performance during EEG-defined "microsleeps." The use of simulators, and in-vehicle detection and alerting devices may mitigate some of the suffering caused by these crashes.     

阻塞性睡眠呼吸暂停综合征患者认知功能研究现状

<正>阻塞性睡眠呼吸暂停综合征(Obstructive sleep apnea syndrome,OSAS)是一种以睡眠中反复出现上气道狭窄或阻塞所致频繁低通气和/或呼吸暂停及睡眠片段化为特征的睡眠紊乱,常伴明显鼾声。国外资料显示,OSAS在成年人中的患病率为3%~7%[1],国内调查显示,OSAS的患病率为3.5%~9.6%,男性患OSAS的风险明显高于女性[2]。由于     

Endoscopic classification of pharyngeal stenosis pattern in obstructive sleep apnea hypopnea syndrome

Twenty-one patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) were classified into three categories according to their pharyngeal stenosis patterns during sleep, as determined from endoscopic findings: (i) a falling type (n = 6); (ii) an all-round type (n = 11); and (iii) a bilateral type (n = 4). In all patients with the bilateral type, the palatine tonsils were hypertrophied, and the apnea-hypopnea indexes (AHI) were improved markedly by surgery. Conversely, the AHI of patients with the falling and all-round types were reduced by a smaller percentage. Surgical therapy is only to be recommended to patients with OSAHS whose pharynx is bilaterally stenotic.