Walker R P, Durazo-Arvizu R, Wachter B, Gopalsami C
Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois 60153, USA.
Laryngoscope. 2001 Sep;111(9):1501-5. doi: 10.1097/00005537-200109000-00001.
OBJECTIVES/HYPOTHESIS: To evaluate the differences between female and male patients with obstructive sleep apnea syndrome (OSAS) in the preoperative period.
Nonrandomized cross-sectional study.
An analysis of 686 patients (111 women and 575 men) with OSAS was completed. Multivariate modeling techniques were employed to correlate gender with the preoperative respiratory disturbance index (RDI), apnea index (AI), hypopnea index (HI), body mass index (BMI), age, and initial symptoms.
At presentation, the male patients were significantly younger and had a lower BMI and a higher RDI and AI than the female patients. For the entire OSAS population studied, the RDI increased as the BMI increased (correlation coefficient [r] = 0.35, P = <.001). For the female patients there was a weaker correlation (r = 0.21, P =.034), and in male patients there was a stronger correlation (r = 0.40, P <.001). For the entire population there was a negative correlation between age and RDI (r = -0.15, P <.001). In female patients there was a nonsignificant correlation (r = -0.09, P =.35), and in male patients the correlation was significant (r = -0.16, P <.001). There was no difference in the reporting of the number of symptoms based on gender (P =.355). Female patients noted headaches on awakening more commonly than male patients (P =.001), and male patients noted snoring (P =.014) and stopping breathing during sleep (P =.001) more often than female patients.
The analysis demonstrated that within a surgical population sample, gender differences exist. The findings of this series were as follows: 1) Apnea severity in women was less weight-dependent than in men; (2) in men there was a significant negative correlation between age and apnea severity; and (3) female and male patients reported the same number of signs or symptoms on presentation, although certain signs and symptoms were more commonly reported based on gender. Current clinical evaluation practices must take into account this gender disparity.
目的/假设：评估阻塞性睡眠呼吸暂停综合征（OSAS）女性和男性患者术前的差异。
非随机横断面研究。
对686例OSAS患者（111例女性和575例男性）进行分析。采用多变量建模技术将性别与术前呼吸紊乱指数（RDI）、呼吸暂停指数（AI）、低通气指数（HI）、体重指数（BMI）、年龄和初始症状进行关联。
就诊时，男性患者比女性患者明显更年轻，BMI更低，RDI和AI更高。对于所研究的整个OSAS人群，RDI随BMI增加而升高（相关系数[r]=0.35，P=<0.001）。女性患者的相关性较弱（r=0.21，P=0.034），男性患者的相关性较强（r=0.40，P<0.001）。对于整个人群，年龄与RDI呈负相关（r=-0.15，P<0.001）。女性患者的相关性不显著（r=-0.09，P=0.35），男性患者的相关性显著（r=-0.16，P<0.001）。基于性别的症状数量报告无差异（P=0.355）。女性患者比男性患者更常报告醒来时头痛（P=0.001），男性患者比女性患者更常报告打鼾（P=0.014）和睡眠中呼吸暂停（P=0.001）。
分析表明，在手术人群样本中存在性别差异。本系列研究结果如下：1）女性呼吸暂停严重程度比男性对体重的依赖性更小；2）男性年龄与呼吸暂停严重程度之间存在显著负相关；3）女性和男性患者就诊时报告的体征或症状数量相同，尽管某些体征和症状基于性别报告更为常见。当前的临床评估实践必须考虑到这种性别差异。
