肥胖和年龄对飞行人员阻塞性睡眠呼吸暂停低通气综合征的影响

目的 分析肥胖和年龄对飞行人员阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的影响,评估其危险性,提出预测飞行人员OSAHS患病情况的简易指标. 方法回顾性分析95例曾在本院睡眠中心和空军航空医学研究所进行整夜多导睡眠图监测的飞行人员的临床资料,依据中华医学会制定的OSAHS诊治指南(草案)进行临床诊断.收集飞行人员Epworth嗜睡量表(ESS)评价嗜睡程度,记录年龄、身高、体重、颈围和腰围,并研究各指标之间的相关性和差异. 结果颈围与呼吸暂停低通气指数(AHI)呈正相关(r=0.405,P<0.01),与最低血氧饱和度(LSaO2)呈负相关(r=-0.252,P<0.01).非OSAHS组和不同程度OSAHS组间颈围、腰围和体质指数(BMI)差异有统计学意义(F=3.670～14.825,P<0.05).颈围≥40 cm组OSAHS患病人数和中重度OSAHS患者所占比例明显增高(x2=11.515～17.589,P<0.01).随着BMI的增加,本组飞行人员中重度OSAHS患病比例增高(x2=6.946,P=0.031).年龄只在非OSAHS和OSAHS组间比较差异有统计学意义(t=-2.118,P=0.037). 结论颈围≥40 cm时患OSAHS的风险增高.颈围、腰围和BMI增加都是OSAHS的危险因素,三者结合可以简便、准确地预测OSAHS的患病情况.年龄可能对OSAHS的发生有影响,但与其严重程度无明显关系.

Effects of obesity and age on pilots with obstructive sleep apnea-hypopnea syndrome

Objective To analyse the effects of obesity and age on pilots with obstructive sleep apnea-hypopnea syndrome (OSAHS), so as to provide a simple and convenient way to anticipate the prevalence and condition of OSAHS in pilots. Methods Ninety-five pilots with suspected OSAHS or healthy were all examined by the polysomnography (PSG) for a whole night. Clinical diagnosis was done according to Diagnosis and Treatment of OSAHS Manual(protocol) drafted by Sleep Apnea Disease Group, Chinese Society of Respiratory Disease, Chinese Medical Association. Data such as Epworth sleepiness scale(ESS) ,age, height, weight, neck circumference and waist circumference were collected. The correlation and difference among the above parameters were analyzed. Results Neck circumference had positive correlation with AHI (r=0. 405, P<0. 01) but negative correlation with lowest oxygen saturation (LSaO2) (r= - 0. 252, P<0. 01). There were significant difference among without OSAHS group and different severity of OSAHS groups in neck circumference, waist circumference and body mass index (BMI) (F=3. 670～14. 825, P<0.05). The ratio of OSAHS patients and moderate and severe patients were higher in neck circumference≥40 cm group than those in neck circumference <40 cm group(x2=11. 515～17. 589, P<0.01). The ratio of moderate and severe OSAHS in pilots increased with increasing BMI(x2 =6. 946, P=O. 031). There was statistical significant difference in age between OSAHS group and without OSAHS group (t = - 2.118, P = 0. 037). Conclusions The possibility of OSAHS increases when neck circumference ≥40 cm. The increase of neck circumference, waist circumference and BMI are all risk factors of OSAHS in pilots. The combination of the three can conveniently and exactly indicate the possibility and severity of OSAHS in pilots. Age may be a potential factor for the presence ofOSAHS, but dose not correlate with severity of OSAHS.