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系统性硬化症患者睡眠呼吸障碍的多导睡眠图检查结果及危险因素

Polysomnography findings and risk factors for sleep-disordered breathing in patients with systemic sclerosis.

作者信息

Çakır Edis Ebru, Mutlucan Eraslan Renginar, Hatipoğlu Osman

机构信息

Department of Pulmonary Medicine, Trakya University Medical Faculty, Edirne, Turkey.

Department of Pulmonary Medicine, Gönen State Hospital, Balıkesir, Turkey.

出版信息

Arch Rheumatol. 2021 Jan 20;36(3):360-365. doi: 10.46497/ArchRheumatol.2021.8415. eCollection 2021 Sep.

Abstract

OBJECTIVES

This study aims to evaluate polysomnography findings and risk factors for sleep-disordered breathing in patients with systemic sclerosis (SSc).

PATIENTS AND METHODS

Thirty-nine patients (2 males, 37 females; mean age: 51.1±12.5 years; range, 21 to 76 years) who attended to the Rheumatology Clinic of Trakya University Medical Faculty between March 2014 and May 2014 were included in the study. Thoracic computed tomography, pulmonary function tests, carbon monoxide diffusion tests, echocardiography, and all-night polysomnography in a sleep laboratory were performed in all patients. Demographic and clinical characteristics of the patients were recorded. The Apnea-Hypopnea Index (AHI) scores were calculated. Disease activity was examined using the Medsger Disease Severity Scale (MDSS). Possible risk factors for sleep-disordered breathing were evaluated.

RESULTS

Using the AHI of ≥5 for obstructive sleep apnea (OSA), 21 (53.8%) of the patients were classified as having OSA. There were no significant differences between the groups with and without OSA in terms of steroid use (p=0.4), CT involvement (p=0.3), and Warrick (p=0.6) and MDSS scores (p=0.5). Age, body mass index (BMI), and mean oxygen desaturation index were found to be significant in the univariate analysis (p<0.1); however, the multivariate analysis revealed only BMI as significant risk factor of OSA (p=0.028). In the multivariate analysis, the mean saturation was found to be significant risk factor for high pulmonary artery pressure (p<0.001).

CONCLUSION

Although OSA is common in SSc, only increased BMI is a significant risk factor of OSA, but not lung involvement, Warrick scores, or MDSS scores.

摘要

目的

本研究旨在评估系统性硬化症(SSc)患者的多导睡眠图结果及睡眠呼吸障碍的危险因素。

患者与方法

纳入2014年3月至2014年5月在特拉凯大学医学院风湿病诊所就诊的39例患者(2例男性,37例女性;平均年龄:51.1±12.5岁;范围21至76岁)。所有患者均接受了胸部计算机断层扫描、肺功能测试、一氧化碳弥散测试、超声心动图检查以及在睡眠实验室进行的整夜多导睡眠图检查。记录患者的人口统计学和临床特征。计算呼吸暂停低通气指数(AHI)得分。使用梅兹格疾病严重程度量表(MDSS)检查疾病活动度。评估睡眠呼吸障碍的可能危险因素。

结果

以阻塞性睡眠呼吸暂停(OSA)的AHI≥5为标准,21例(53.8%)患者被归类为患有OSA。在使用类固醇情况(p=0.4)、CT受累情况(p=0.3)、沃里克评分(p=0.6)和MDSS评分(p=0.5)方面,有OSA组和无OSA组之间无显著差异。在单因素分析中,年龄、体重指数(BMI)和平均氧饱和度下降指数具有统计学意义(p<0.1);然而,多因素分析显示只有BMI是OSA的显著危险因素(p=0.028)。在多因素分析中,平均饱和度是肺动脉高压的显著危险因素(p<0.001)。

结论

尽管OSA在SSc中很常见,但只有BMI升高是OSA的显著危险因素,而肺部受累、沃里克评分或MDSS评分则不是。

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