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吸烟对阻塞性睡眠呼吸暂停综合征患者的影响。

Effects of smokıng on patıents wıth obstructıve sleep apnea syndrome.

作者信息

Yosunkaya Sebnem, Kutlu Ruhusen, Vatansev Hülya

机构信息

Department of Chest Disease Meram Medical Faculty of Necmettin, Ebakan University, Konya, Turkey.

Department of Family Medicine Meram Medical Faculty of Necmettin, Ebakan University, Konya, Turkey.

出版信息

Clin Respir J. 2021 Feb;15(2):147-153. doi: 10.1111/crj.13278. Epub 2020 Oct 7.

Abstract

OBJECTIVES

We aimed to investigate the relationship between the presence and severity of obstructive sleep apnea (OSAS) and smoking using pulmonary function tests and polysomnographic data.

MATERIALS AND METHODS

This analytical cross-sectional study was done by retrospectively examining the files of patients who applied to the Meram Medical Faculty Chest Diseases Sleep Laboratory between 07.01.2016 and 30.12.2018. Three-hundred and thirty-three patients who were diagnosed with OSAS or simple snoring by polysomnography (PSG) were included in the study.

RESULTS

Those involved in the study; 17.1% were simple snoring [apnea-hypopnea index (AHI) < 5]; 15.3% were mild OSAS (AHI: 5-15); 30.6% were moderate OSAS (AHI: 16-30); 36.9% were severe OSAS (AHI > 30), and 48.6% of the study participants never smoked. There was a significant correlation between the number of pack-years, minimum O saturation, mean O saturation, ratio of sleep time to total sleep time with oxygen saturation below 90%, %NREM 3 sleep time, Hb, HTC values, and FEV1/FVC values. According to the results of multiple linear regression analysis; the effect of package-year, age, and BMI on OSAS severity was found to be statistically significant (β = 0.153 P = 0.004, β = 0.123 P = 0.025, β = 0.208 P < 0.001, respectively).

CONCLUSION

It was revealed that patients with severe OSAS were heavy smokers, and increased smoking increased the OSAS severity both by increasing the AHI and by reducing the oxygen saturation overnight. One unit increase in the package-year results in a 15.3% increase in the AHI.

摘要

目的

我们旨在利用肺功能测试和多导睡眠图数据,研究阻塞性睡眠呼吸暂停(OSAS)的存在及严重程度与吸烟之间的关系。

材料与方法

本分析性横断面研究通过回顾性检查2016年1月7日至2018年12月30日期间申请进入梅拉姆医学院胸部疾病睡眠实验室的患者档案进行。纳入了333例经多导睡眠图(PSG)诊断为OSAS或单纯打鼾的患者。

结果

参与研究的患者中,17.1%为单纯打鼾[呼吸暂停低通气指数(AHI)<5];15.3%为轻度OSAS(AHI:5 - 15);30.6%为中度OSAS(AHI:16 - 30);36.9%为重度OSAS(AHI>30),且48.6%的研究参与者从不吸烟。吸烟包年数、最低血氧饱和度、平均血氧饱和度、睡眠时血氧饱和度低于90%的时间占总睡眠时间的比例、非快速眼动睡眠3期睡眠时间、血红蛋白(Hb)、血细胞比容(HTC)值以及第一秒用力呼气容积/用力肺活量(FEV1/FVC)值之间存在显著相关性。根据多元线性回归分析结果,发现吸烟包年数、年龄和体重指数(BMI)对OSAS严重程度的影响具有统计学意义(β分别为0.153,P = 0.004;β为0.123,P = 0.025;β为0.208,P < 0.001)。

结论

结果显示,重度OSAS患者为重度吸烟者,吸烟量增加会通过提高AHI以及降低夜间血氧饱和度来加重OSAS的严重程度。吸烟包年数每增加一个单位,AHI会增加15.3%。

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