体位改变对阻塞性睡眠呼吸暂停低通气综合征患者睡眠结构和呼吸事件的影响

目的：研究OSAHS患者体位改变对睡眠结构、呼吸事件的影响并进行相关分析。方法：对80例OSAHS患者行ESS嗜睡量表评分,并按AHI分为OSAHS轻度组（5≤AHI〈15）、中度组（15≤AHI〈30）和重度组（AHI≥30）,比较不同程度的OSAHS患者在不同体位时的睡眠结构、呼吸事件之间的差异。结果：体位发生改变时,OSAHS重度组与轻、中度组比较,REM%、NREM%、NREM LSaO2、RDI、仰卧位呼吸暂停指数（SAHI）及侧卧位呼吸暂停指数（L-AHI）差异均有统计学意义（P〈0.05）。OSAHS重度组与轻度组比较,MSaO2、LSaO2差异均有统计学意义（P〈0.05）。OSAHS中度组与轻度组比较,LSaO2、REM LSaO2及RDI差异均有统计学意义（P〈0.05）。3组的LT%均高于ST%,但其差异无统计学意义（P〉0.05）。S-AHI、L-AHI与轻、中度组ESS评分无相关性（P〉0.05）,而L-AHI与重度ESS评分极显著性相关（r=0.551,P〈0.01）,REM L-AHI和NREM L-AHI与重度ESS评分极显著性相关（r分别为0.516、0.528,均P〈0.01）。结论：L-AHI、NREM LAHI、REM L-AHI和NREM LSaO2可作为监测重度OSAHS严重程度的稳定参数,而REM LSaO2主要反映轻、中度OSAHS患者的病情严重程度。

Effects of sleeping body posture on sleeping structure and respiratory events in patients with OSAHS

Objective：To observe the effects of sleeping body posture on sleeping structure and respiratory events in patients with OSAHS.Method：We assessed the sleeping body position,the sleeping structure,position specific AHI and the Epworth Sleepiness Scale（ESS）in a total of 80patients with Positional OSAHS.The patients were grouped according to AHI：mild OSAHS（5≤AHI15）,moderate（15≤AHI30）and severe（AHI≥30）.The polysomnography data and clinical characteristics were compared between each group.Result： The severe OSAHS group,when compared with the mild and the moderate ones,had a significant different in REM%,NREM%,NREM LSaO2,RDI,S-AHI and L-AHI due to posture（P〈0.05）.The severe and the mild OSAHS groups had significant different in MSaO2,LSaO2 due to posture（P〈0.05）.The moderate and the mild OSAHS group had significant different in LSaO2,REM LSaO2 and RDI（P〈0.05）.In all mild,moderate and severe groups,the LT% were higher than ST%,but the difference was not significant（P〈0.05）.For mild-to-moderate groups,there was no correlation between the ESS and the AHI for any position different（P〈0.05）.For severe group,the ESS was significantly correlated with L-AHI（r=0.551;P〈0.01）;the REM L-AHI and NREM L-AHI was also significantly correlated with ESS of severe group（r were 0.516and 0.528,P〈0.01）.Conclusion：The L-AHI,NREM L-AHI,REM L-AHI and NREM LSaO2 were considered to monitor the stability of OSAHS,while REM LSaO2 were consider to clarify the severity of OSAHS.