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阻塞性睡眠呼吸暂停综合征患者的心血管和代谢合并症。

Cardiovascular and metabolic comorbidities in patients with obstructive sleep apnoea syndrome.

机构信息

Department of Applied Clinical Sciences, University of L'Aquila, Italy.

出版信息

Acta Otorhinolaryngol Ital. 2012 Oct;32(5):320-5.

Abstract

The purpose of this study was to evaluate the correlation between severity of obstructive sleep apnoea syndrome (OSAS), cardiovascular disease and metabolic syndrome. We recruited 1185 patients with OSAS who underwent a complete ENT examination, including nasolaryngeal fibre optic endoscopy with Müller's manoeuvre, overnight cardio-respiratory monitoring, Epworth Sleepiness Scale (ESS) to measure daytime sleepiness, body mass index (BMI), measurement of blood pressure and blood tests.SUBSEQUENTLY, SUBJECTS WERE DIVIDED INTO THREE SUBGROUPS ACCORDING TO THE APNOEA HYPOPNOEA INDEX (AHI): mild OSAS (AHI 5-15), moderate OSAS (AHI 15-30) and severe OSAS (AHI > 30). In the sample collected, 347 (262 males and 85 females) of 1185 patients suffered from mild OSAS, 363 (269 males and 94 females) from moderate OSAS and 475 (330 males and 145 females) from severe OSAS. In the group suffering from mild OSAS, we found: 127 patients affected by hypertension, 48 with diabetes, 11 with dyslipidaemia and 32 with metabolic syndrome. In the group with moderate OSAS there were 157 patients with hypertension, 63 with diabetes, 72 with dyslipidaemia and 47 with metabolic syndrome. In the group suffering from severe OSAS there were 244 patients with hypertension, 138 with diabetes, 47 with dyslipidaemia and 90 with metabolic syndrome. For data analysis, we used the Spearman correlation test adjusted according to Sidak between the dependent variable AHI and the independent variables BMI, ESS, average SO2 (SO(2med)), hypertension, diabetes mellitus, dyslipidaemia and metabolic syndrome. The results show different patterns of correlation in terms of statistical significance: BMI ρ(s) = 0.26, SO(2med) ρ(s) = -0:51, hypertension ρ(s) = -0.05, dyslipidaemia ρ(s) = 0.22 for women, and BMI ρ(s) = 0.53, ESS ρ(s) = 0.28, SO(2med) ρ(s) = -0.50, hypertension ρ(s) = 0.17, diabetes mellitus ρ(s) = 0.28 and metabolic syndrome ρ(s) = 0.26 for men. The results of the study confirm the existence of a statistically significant correlation between the severity of OSAS and BMI, ESS, average SO2, hypertension, diabetes mellitus, dyslipidaemia and metabolic syndrome.

摘要

本研究旨在评估阻塞性睡眠呼吸暂停综合征(OSAS)严重程度与心血管疾病和代谢综合征之间的相关性。我们招募了 1185 名患有 OSAS 的患者,对他们进行了全面的耳鼻喉检查,包括鼻腔纤维光内窥镜检查和 Müller 手法、整夜心肺监测、Epworth 嗜睡量表(ESS)以测量白天嗜睡、体重指数(BMI)、血压测量和血液检查。随后,根据呼吸暂停低通气指数(AHI)将受试者分为三组:轻度 OSAS(AHI 5-15)、中度 OSAS(AHI 15-30)和重度 OSAS(AHI > 30)。在收集的样本中,1185 名患者中有 347 名(262 名男性和 85 名女性)患有轻度 OSAS,363 名(269 名男性和 94 名女性)患有中度 OSAS,475 名(330 名男性和 145 名女性)患有重度 OSAS。在轻度 OSAS 组中,我们发现:127 名患者患有高血压,48 名患有糖尿病,11 名患有血脂异常,32 名患有代谢综合征。在中度 OSAS 组中,有 157 名患者患有高血压,63 名患有糖尿病,72 名患有血脂异常,47 名患有代谢综合征。在重度 OSAS 组中,有 244 名患者患有高血压,138 名患有糖尿病,47 名患有血脂异常,90 名患有代谢综合征。为了进行数据分析,我们使用了根据 Sidak 调整的 Spearman 相关性检验,比较了依赖变量 AHI 与独立变量 BMI、ESS、平均 SO2(SO(2med))、高血压、糖尿病、血脂异常和代谢综合征之间的关系。结果表明,在统计学意义上存在不同的相关性模式:女性的 BMI ρ(s) = 0.26,SO(2med) ρ(s) = -0.51,高血压 ρ(s) = -0.05,血脂异常 ρ(s) = 0.22,而男性的 BMI ρ(s) = 0.53,ESS ρ(s) = 0.28,SO(2med) ρ(s) = -0.50,高血压 ρ(s) = 0.17,糖尿病 ρ(s) = 0.28 和代谢综合征 ρ(s) = 0.26。研究结果证实,OSAS 严重程度与 BMI、ESS、平均 SO2、高血压、糖尿病、血脂异常和代谢综合征之间存在统计学上显著的相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e311/3546405/90f0af75ab6d/0392-100X-32-320-g001.jpg

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