Nigro Carlos A, Rhodius Edgardo E
Laboratorio de Sueño, Servicio de Neumonología, Hospital Alemán, Buenos Aires, Argentina.
Medicina (B Aires). 2003;63(2):119-24.
The objective of this study was to determine whether different decreases in oxygen saturation (SaO2) or the presence of electroencephalographic arousals (EEGA) in the definition of hypopnea modify hypopnea index and apnea/hypopnea index and the prevalence of obstructive sleep apnea/hypopnea syndrome (OSAHS). A total of 20 polysomnographies performed in patients with OSAHS were analyzed. There are four different definitions of hypopnea: > or = 30% reduction in airflow or 50% decrease in abdominal movement associated with decreases SaO2 > or = 3% (type 1); decreases SaO2 > or = 3% or EEGA (type 2); decreases SaO2 > or = 4% (type 3); decreases SaO2 > or = 4% or EEGA (type 4). The prevalence of OSAHS was calculated for an apnea/hypopnea index (AHI) > or = 10 and > or = 15. Hypopnea index (HI) and AHI types 2 and 4 were higher than type 3 (HI: type 2: 20 +/- 10.6, type 4: 18.6 +/- 10, type 3: 11.4 +/- 10, p < 0.001; AHI: type 2: 23.3 +/- 11.6, type 4: 21.4 +/- 11.2, type 3: 14.7 +/- 11.6, p < 0.001). No differences were observed between HI and AHI types 1 and 2 (HI: type 1: 17.4 +/- 10, type 2: 20 +/- 10.6; AHI: type 1: 20.6 +/- 11.8, type 2: 23 +/- 11.6, p > 0.05). The prevalence of OSAHS was 30-55% in type 3, 70-85% in type 4 (p < 0.05), and 70-85% in types 1 and 2 (p > 0.05). In our patient's population, the presence of EEGA in the definition of hypopnea significantly increased the HI, the AHI and the prevalence of OSAHS when associated with a > or = 4% decrease in SaO2.
本研究的目的是确定低通气定义中不同程度的氧饱和度（SaO₂）下降或脑电图觉醒（EEGA）的存在是否会改变低通气指数和呼吸暂停/低通气指数以及阻塞性睡眠呼吸暂停/低通气综合征（OSAHS）的患病率。对20例OSAHS患者进行的多导睡眠图检查进行了分析。低通气有四种不同的定义：气流减少≥30%或腹部运动减少50%且伴有SaO₂下降≥3%（1型）；SaO₂下降≥3%或EEGA（2型）；SaO₂下降≥4%（3型）；SaO₂下降≥4%或EEGA（4型）。计算呼吸暂停/低通气指数（AHI）≥10和≥15时OSAHS的患病率。2型和4型的低通气指数（HI）和AHI高于3型（HI：2型：20±10.6，4型：18.6±10，3型：11.4±10，p<0.001；AHI：2型：23.3±11.6，4型：21.4±11.2，3型：14.7±11.6，p<0.001）。1型和2型的HI和AHI之间未观察到差异（HI：1型：17.4±10，2型：20±10.6；AHI：1型：20.6±11.8，2型：23±11.6，p>0.05）。3型中OSAHS的患病率为30 - 55%，4型中为70 - 85%（p<0.05），1型和2型中为70 - 85%（p>0.05）。在我们的患者群体中，当低通气定义中存在EEGA且与SaO₂下降≥4%相关时，会显著增加HI、AHI以及OSAHS的患病率。
