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甲状腺功能减退症的发病率及其与阻塞性睡眠呼吸暂停多导睡眠图结果的相关性。

Incidence of hypothyroidism and its correlation with polysomnography findings in obstructive sleep apnea.

作者信息

Ozcan K Murat, Selcuk Adin, Ozcan Ibrahim, Ozdas Talih, Ozdogan Fatih, Acar Mustafa, Dere Huseyin

机构信息

ENT Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey.

出版信息

Eur Arch Otorhinolaryngol. 2014 Nov;271(11):2937-41. doi: 10.1007/s00405-014-2962-1. Epub 2014 Mar 8.

Abstract

The aim of this study is to investigate the thyroid functions and its correlation with polysomnography findings in obstructive sleep apnea patients. This study was conducted on 203 patients evaluated with the complaints of snoring, witnessed apnea and daytime sleepiness and established polysomnography (PSG) indication between May 2008 and August 2011. All patients' nocturnal PSG recordings were carried out. The thyroid function was classified as euthyroid, subclinical hypothyroidism and clinical hypothyroidism after analyzing serum TSH and free T4 values. The correlation between the data obtained from PSG records and thyroid function values was statistically compared. Apnea hypopnea index obtained from PSG was in the range of 5.4-132.9/h, and mean value was 32.7/h. The lowest oxygen saturation level was in the range of 20-92 %, and the mean value was 76.4 %. According to PSG results, 55 patients (27.09 %) had mild obstructive sleep apnea syndrome (OSAS), 48 patients (23.65 %) had moderate OSAS and 100 patients (49.26 %) had severe OSAS. On evaluation of the thyroid function test results, 10.8 % (n = 22) of the patients were defined to have subclinical hypothyroidism and 1.97 % (n = 4) clinical hypothyroidism. We found a total of 12.77 % subclinical and clinical hypothyroidism in patients with OSAS. Though the incidence of hypothyroidism was pretty high in patients with OSA, there was no statistically significant correlation between thyroid functions and polysomnography findings. We suggest that evaluation of the thyroid functions is important and necessary in patients with OSAS. Polysomnography findings do not correlate statistically with thyroid function tests, addressing the need for thyroid screening for all OSAS patients.

摘要

本研究旨在调查阻塞性睡眠呼吸暂停患者的甲状腺功能及其与多导睡眠图检查结果的相关性。本研究对2008年5月至2011年8月期间因打鼾、目击性呼吸暂停和日间嗜睡等症状接受评估并符合多导睡眠图(PSG)检查指征的203例患者进行。所有患者均进行了夜间PSG记录。分析血清促甲状腺激素(TSH)和游离甲状腺素(T4)值后,将甲状腺功能分为甲状腺功能正常、亚临床甲状腺功能减退和临床甲状腺功能减退。对PSG记录获得的数据与甲状腺功能值之间的相关性进行统计学比较。PSG获得的呼吸暂停低通气指数范围为5.4 - 132.9次/小时,平均值为32.7次/小时。最低血氧饱和度水平范围为20% - 92%,平均值为76.4%。根据PSG结果,55例患者(27.09%)患有轻度阻塞性睡眠呼吸暂停综合征(OSAS),48例患者(23.65%)患有中度OSAS,100例患者(49.26%)患有重度OSAS。评估甲状腺功能测试结果时,10.8%(n = 22)的患者被诊断为亚临床甲状腺功能减退,1.97%(n = 4)的患者为临床甲状腺功能减退。我们发现OSAS患者中亚临床和临床甲状腺功能减退的总发生率为12.77%。虽然OSA患者中甲状腺功能减退的发生率相当高,但甲状腺功能与多导睡眠图检查结果之间无统计学显著相关性。我们建议对OSAS患者进行甲状腺功能评估是重要且必要的。多导睡眠图检查结果与甲状腺功能测试无统计学相关性,这表明所有OSAS患者都需要进行甲状腺筛查。

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