中重度阻塞性睡眠呼吸暂停低通气综合征患者生活质量评价及持续气道正压治疗作用

[目的]评价中重度睡眠呼吸暂停低通气综合征（OSAHS）患者生活质量及持续气道正压（CPAP）治疗对患者生活质量的影响.[方法]选择多导睡眠图（PSG）确诊的中重度OSAHS患者101例,经患者知情同意分为CPAP治疗患者55例（治疗组）、未治疗患者46例（对照组）.采用Calgary生活质量指数（SAQLI）评价OSAHS患者生活质量,Epworth嗜睡评分（ESS）量表评价患者的白天过度嗜睡（EDS）程度,比较两组治疗前和治疗后2个月的SAQLI、EDS、PSG和体重指数（BMI）等指标,多因素Logistic回归分析SAQLI评分与PSG、ESS、BMI的相关性.[结果]治疗组SAQLI评分的日常生活、社会交往、情感功能、OSA症状及SAQLI总分、ESS评分分别为（3.90±1.03）、（4.43±1.31）、（4.98±1.37）、（2.87±1.22）、（3.85±1.18）和（14.85±4.8）,与治疗后（5.39±1.21）、（5.07±1.38）、（5.55±1.46）、（3.45±1.36）、（4.66±1.32）和（9.10±3.1）比较均有统计学差异（P〉0.05）;治疗组治疗前呼吸紊乱指数（RDI）、最长呼吸暂停时间（Tmax）、氧饱和度低于90%时间占总睡眠时间百分比（T90）、最低氧饱和度（LSpO2）为（52.1±21.0）、（71.2±22.8）、（40.5±18.1）、（77.3±14.5）与治疗后（11.8±10.4）、（28.5±10.5）、（21.2±6.8）、（88.7±10.4）比较均有显著性差异（P〈0.01）;Logistic回归分析显示RDI和ESS是影响SAQLI总分的独立危险因素.[结论]中重度OSAHS患者生活质量降低;生活质量降低与RDI和EDS程度有关;CPAP治疗可显著改善中重度OSAHS患者生活质量

Evaluation of Quality of Life in Patients with Moderate to Severe Obstructive Sleep Apnea Hypoventilation Syndrome and the Effect of Continuous Positive Airway Pressure Treatment

[Objective]To explore the quality of life in patients with moderate to severe obstructive sleep apnea and hypoventilationsyndrome（OSAHS） and the effect of continuous positive airway pressure（CPAP） treatment. [Methods] Totally 101 patients with moderate to severe OSAHS diagnosed by polysomnography（PSG） were selected and divided into CPAP group（treatment group, n = 55） and non-treatment group（control group, n=46） after informed consent of patients. Calgary sleep apnea quality of life index（SAQLI） was used to evaluate the quality life of OSAHS patients. Epworth sleepiness score（ESS） scale was used to evaluate the degree of excessive daytime sleepiness（EDS） of patients. The indices such as SAQLI, EDS, PSG and body mass index（BMI） in two groups were compared between before and 2 months after treatment. The correlation between SAQLI score and PSG, ESS and BMI was analyzed by multifactor logistic regression. [Results] SAQLI scores of daily life, social interactions, emotional function and OSA symptoms, total SAQLI score and ESS score in treatment group were 3.90±1.03, 4.43±1.31, 4.98±1.37, 2.87±1.22, 3.85±1.18 and 14.85± 4.8, respectively. There were significant differences in above scores between before and after treatment（5.39± 1.21, 5.07±1.38, 5.55±1.46, 3.45±1.36, 4.66±1.32 and 9.10± 3.1 respectively, P 〉0.05）. There were significant differences in respiratory disturbance index（RDI）, the longest apnea time（Tmax）, the percentage of recording time with oxygen saturation of 90% or less（T90） and the lowest oxygen saturation（LSpO2 ） between before and after treatment（52.1 ±21.0 vs 11.8 ±10.4, 71.2±22.8 vs 28.5 ± 10.5, 40.5±18.1 vs 21.2±6.8, 77.3±14.5 vs 88.7±10.4, all P 〈0.01）. Logistic regression analysis showed that RDI and ESS were independent risk factors of total scores of SAQLI. [Conclusion] The quality of life in patients with moderate to severe OSAHS decreases. The decreasing of quality of life is associated with the degree of RDI and EDS. CPAP treatment can obviously improve the quality of life in patients with moderate to severe OSAHS.