TS90%评估阻塞性睡眠呼吸暂停低通气综合征低氧血症程度的临床价值

目的探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者低氧血症程度的判断指标。方法分析经多导睡眠呼吸监测仪诊断的108例OSAHS患者和37例单纯鼾症的多导睡眠监测资料。参照杭州会议诊断标准,计算最低血氧饱和度（MiO2）和血氧饱和度〈90％时间占监测总时间的百分比（TS90％）与呼吸暂停低通气指数（AHI）的相关系数。结果随OSAHS严重程度的增高,TS90％数值也逐渐增高,而MiO2值逐渐下降（TS90％、MiO2在单纯鼾症、轻度OSAHS、中度OSAHS、重度OSAHS分别为1．47、82．00,4．23、80．00,12．85、74．00,37．82、62．00）,差异有统计学意义（均P〈0．001）。TS90％与AHI和患者主观感觉嗜睡分值（ESS）的相关性均高于MiO2。结论TS90％能较为客观地反映患者睡眠时低氧血症的严重程度,与MiO2相参照则能整体地、客观地反映患者的缺氧程度。

Clinical value of TS90% in evaluation of hypoxemia in patients with obstructive sleep apnea/hypoventilation syndrome

Objective To explore the appropriate study how to properly evaluate the hypoxemiadegree in patients with obstructive sleep apnea/hypoventilation syndrome(OSAHS).Methodspolysomnography was conducted on 108 OSAHS patients and 37 simple snorers to record the minimumoxygen saturation level(MiO2) and the total recorded time spent below90% oxygen saturation(TS90%).The correlation between MiO2and the percent of the total recorded time spent below90% oxygen saturation(TS90%) with the AHI were calculated.Results The value of TS90% was significantly increased,andthe value of MiO2was significantly decreased as the severity of OSAHS increased(allP<0.001).Thecorrelation coefficients of TS90% with AHI and with Epworth sleepiness scale(ESS) were both much higherthan those of MiO2.Conclusion TS90% can express the severity of hypoxemia of the OSAHS patients morecorrectly than MiO2.TS90% combined with MiO2can comprehensively and objectively reflect the severity ofhypoxia of the OSAHS patients.