[阻塞性睡眠呼吸暂停低通气综合征患者睡眠呼吸暂停发作的持续时间和频率与低氧血症的相关性]

[Correlations between the duration and frequency of sleep apnea episode and hypoxemia in patients with obstructive sleep apnea syndrome].

作者信息

Li Qi, Jin Xiao-Jie

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai 200001, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2009 Oct;44(10):825-30.

PMID:20079052

Abstract

OBJECTIVE

To evaluate the relationship between the duration of apnea episodes and the severity of hypoxemia of obstructive sleep apnea-hypopnea syndrome (OSAHS) patients and explore the possible causes of the disassociation between the severity of hypoxemia and AHI in some OSAHS subjects.

METHODS

Polysomnography data of eighty-two OSAHS patients was analyzed. Firstly, apnea and hypopnea events were classified into 4 groups respectively according to it's lengths, i.e., longer or equals to 10 s, 15 s, 20 s, 25 s, AHI10, AHI15, AHI20, AHI25 were obtained by calculating apnea hypopnea events per hour with respective lengths. Secondly, total apnea time per hour was calculated in all cases. Thirdly Spearman correlation coefficient and Linear regression analysis were used to measure the associations between numerical parameters referred above and three parameters of hypoxia: the lowest oxygen saturation level (LSaO2), the mean oxygen saturation level during sleep time (MeanSaO2), the percent of the total recorded time spent below 0.90 oxygen saturation level (TS90).

RESULTS

The apnea-hypopnea index (AHI10, AHI15, AHI20, AHI25) correlated negatively with the LSaO2 (r was -0.636, -0.634, -0.649, -0.657), P < 0.01. The apnea-hypopnea index (AHI10, AHI15, AHI20, AHI25) correlated negatively with the MeanSaO2 (r was -0.659, -0.647, -0.648, -0.629), P < 0.01. The apnea-hypopnea index (AHI10, AHI15, AHI20, AHI25) correlated positively with the TS90 (r was 0.810, 0.806, 0.806, 0.770), P < 0.01. Further linear regression analysis all showed significant clinical value with r(2) > 0.50. The amount time of apnea events per hour of total sleep time (T) showed high correlations with LSaO2, MeanSaO2, TS90 (r was -0.650, -0.628, 0.776), while P < 0.01.

CONCLUSIONS

The duration of apnea episodes has a significant clinical value in accessing the degree of hypoxia of the OSAHS patients. The TS90 combined with the LSaO2 reflects the severity of hypoxia of the OSAHS patients objectively.

摘要

目的

评估阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者呼吸暂停发作持续时间与低氧血症严重程度之间的关系，并探讨部分OSAHS患者低氧血症严重程度与呼吸暂停低通气指数（AHI）解离的可能原因。

方法

分析82例OSAHS患者的多导睡眠图数据。首先，将呼吸暂停和低通气事件按其持续时间分别分为4组，即≥10秒、15秒、20秒、25秒，通过计算每小时相应持续时间的呼吸暂停低通气事件数获得AHI10、AHI15、AHI20、AHI25。其次，计算所有病例每小时的总呼吸暂停时间。第三，采用Spearman相关系数和线性回归分析来测量上述数值参数与低氧血症的三个参数之间的关联：最低血氧饱和度水平（LSaO2）、睡眠时间的平均血氧饱和度水平（MeanSaO2）、血氧饱和度低于0.90水平的总记录时间百分比（TS90）。

结果

呼吸暂停低通气指数（AHI10、AHI15、AHI20、AHI25）与LSaO2呈负相关（r分别为-0.636、-0.634、-0.649、-0.657），P<0.01。呼吸暂停低通气指数（AHI10、AHI15、AHI20、AHI25）与MeanSaO2呈负相关（r分别为-0.659、-0.647、-0.648、-0.629），P<0.01。呼吸暂停低通气指数（AHI10、AHI15、AHI20、AHI25）与TS90呈正相关（r分别为0.810、0.806、0.806、0.770），P<0.01。进一步的线性回归分析均显示具有显著临床价值，r(2)>0.50。总睡眠时间（T）中每小时呼吸暂停事件的时长与LSaO2、MeanSaO2、TS90高度相关（r分别为-0.650、-0.628、0.776），P<0.01。