非肥胖型阻塞性睡眠呼吸暂停综合征的呼吸障碍特点

目的分析非肥胖型阻塞性睡眠呼吸暂停综合征（OSAS）的呼吸障碍特点。方法我院2007年3月至2008年2月确诊的136例OSAS患者中体质指数≤25的患者36例为非肥胖组，另选择年龄、性别相匹配的36例肥胖型OSAS患者作为肥胖组。比较2组睡眠呼吸障碍的指标。结果非肥胖型OSAS患者的呼吸暂停指数、夜间缺氧时间少于肥胖型OSAS患者，夜间最低血氧饱和度高于肥胖型OSAS患者，差异有统计学意义（P〈0．05）。2组的平均呼吸暂停时间差异无统计学意义（P〉0．05），非肥胖组中混合性呼吸暂停占的比例较大。病情严重度方面，非肥胖型OSAS以中度和轻度为主，肥胖型OSAS以重度为主。结论非肥胖型OSAS患者相对于同龄、同性别的肥胖型OSAS患者睡眠呼吸障碍程度较轻，混合性呼吸暂停占的比例较大，推测非肥胖型OSAS发病机制可能与中枢驱动和上气道的神经调节有关。

Respiration disorders in non-obese obstructive sleep apnea syndrome

Objective To investigate the features of respiration disorders in non-obese obstructive sleep apnea syndrome(OSAS). Methods All patients underwent overnight polysomnography. 36 OSAS patients with body mass index (BMI) ≤25 were enrolled into non-obese group; 36 age and sex-matched OSAS controls with BMI > 25 were enrollled into obese group. Features of respiration disorders in two groups were analyzed. Results Compared with obese OSAS, non-obese OSAS had less apnea indices (AI) and time of nocturnal oxygen saturation lower 90% (T-SaO2< 90%) and higher lowest nocturnal oxygen saturation (MinSaOz). There was no significant difference in average apnea time in two groups. For the severity of OSAS, non-obese had more mild, moderate individuals and obese had more severe individuals. Except obstructive sleep apnea, non-obese OSAS had higher ratio of mixed sleep apnea than obese OSAS (15.2% vs 6.1%, P < 0.01). Conclusion Compared with age and sex-matched obese OSAS, non-obese OSAS has less respiration disorders and higher ratio of mixed sleep apnea. Abnormal nerve accommodation in upper airway or respiratory center may play an important role in pathogenesis of non-obese OSAS.