OSAHS患者睡眠呼吸事件与继之发生的低氧血症的关系及临床意义

目的：探讨阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者睡眠呼吸事件与继之发生的低氧血症的关系及临床意义。方法：选取夜间打鼾并疑有睡眠呼吸障碍者45例，分为4组：正常打鼾组、轻度OSAHS组、中度OSAHS组和重度OSAHS组。填写Epworth嗜睡问卷，并进行整夜睡眠监测，记录各项睡眠参数及每次睡眠呼吸事件开始至随之出现血氧饱和度下降的时间，定义为氧减延迟时间。结果：45例患者均发生了阻塞性睡眠呼吸事件。中度OSAHS组的平均氧减延迟时间大于正常打鼾组（P〈0．05）和轻度OSAHS组（P〈0．05），重度OSAHS组的平均氧减延迟时间也大于正常打鼾组（P〈0．01）和轻度OSAHS组（P〈0．01），而正常打鼾组和轻度OSAHS组间（P〉0．05）、中度OSAHS组和重度OSAHS组间（P〉0．05）差异无统计学意义；平均氧减延迟时间与呼吸暂停指数（AHI）呈线性正相关（r=0．608，P〈0．01）、与最低血氧饱和度（LSaO2）呈线性负相关（r=-0．543，P〈0．01）；平均氧减延迟时间与Epworth问卷前7项总分（ESS7）的相关性（r=0．689，P〈0．01）高于AHI、LSaO2与ESS7的相关性（r=0．486，P〈0．01；r=-0．422，P〈0．01）。结论：氧减延迟时间是描述血氧变化对阻塞性睡眠呼吸事件敏感性的指标，本研究中、重度OSAHS患者平均氧减延迟时间较正常打鼾者和轻度OSAHS患者明显延长；平均氧减延迟时间分别与AHI、LSaO2密切相关；其与ESS7的相关性大于AHI、LSaO2与ESS7的相关性，提示平均氧减延迟时间在一定程度上能反映OSAHS患者病情严重程度，在反映患者白天嗜睡程度方面优于AHI和LSaO2。

The relationship between sleep episode and hypoxemia which following it in patients with obstructive sleep apnea-hypopnea syndrome and its clinical significance

Objective:To explore the relationship between sleep respiratory events and hypoxemia followingobstructive sleep apnea-hypopnea syndrome(OSAHS)and its clinical significance.Method:Forty-five patients suffered from snoring and suspected of sleep breathing disorders were measured by a Chinese version of Epworth Sleepiness Scale and tested by polysomnography all night long.Some ordinary polysomnographic parameters were recorded in all cases as well as the delay period of desaturation which means the duration fr...