Bikov András, Frent Stefan, Deleanu Oana, Meszaros Martina, Birza Mariela Romina, Popa Alina Mirela, Manzur Andrei Raul, Gligor Loredana, Mihaicuta Stefan
Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Oxford Road, Manchester M13 9WL, UK.
Division of Infection, Immunity & Respiratory Medicine, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, UK.
J Clin Med. 2023 Jun 22;12(13):4205. doi: 10.3390/jcm12134205.
Nocturnal hypoxaemia measured as the percentage of total sleep time spent with saturation below 90% (TST90%) may better predict cardiovascular consequences of obstructive sleep apnoea (OSA) than the number of obstructive respiratory events measured with the apnoea-hypopnea index (AHI). Deeper hypoxaemia may potentially induce more severe pathophysiological consequences. However, the additional value of the percentage of total sleep time spent with saturation below 80% (TST80%) to TST90% is not fully explored.
Comprehensive medical history was taken and fasting lipid and C-reactive protein levels were measured in 797 volunteers participating in two cohort studies in Hungary and Romania. Sleep parameters, including AHI, TST90% and TST80%, were recorded following a polysomnography (PSG, = 598) or an inpatient cardiorespiratory polygraphy ( = 199). The performance of TST80% to predict cardiovascular risk was compared with TST90% using linear and logistic regression analyses as well receiver operating characteristics curves. Sensitivity analyses were performed in patients who had PSG, separately.
Both parameters are significantly related to cardiovascular risk factors; however, TST80% did not show better predictive value for cardiovascular risk than TST90%. On the other hand, patients with more severe hypoxaemia reported more excessive daytime sleepiness.
TST80% has limited additional clinical value compared to TST90% when evaluating cardiovascular risk in patients with OSA.
以睡眠中血氧饱和度低于90%的总睡眠时间百分比(TST90%)来衡量的夜间低氧血症,相较于用呼吸暂停低通气指数(AHI)测量的阻塞性呼吸事件数量,可能能更好地预测阻塞性睡眠呼吸暂停(OSA)的心血管后果。更深程度的低氧血症可能会引发更严重的病理生理后果。然而,血氧饱和度低于80%的总睡眠时间百分比(TST80%)相对于TST90%的附加价值尚未得到充分研究。
对参与匈牙利和罗马尼亚两项队列研究的797名志愿者进行了全面的病史采集,并测量了空腹血脂和C反应蛋白水平。在进行多导睡眠图检查(PSG,n = 598)或住院心肺多导睡眠监测(n = 199)后,记录睡眠参数,包括AHI、TST90%和TST80%。使用线性和逻辑回归分析以及受试者工作特征曲线,比较TST80%和TST90%预测心血管风险的性能。对进行了PSG检查的患者分别进行敏感性分析。
这两个参数均与心血管危险因素显著相关;然而,TST80%对心血管风险的预测价值并不比TST90%更好。另一方面,低氧血症更严重的患者报告有更多的日间过度嗜睡。
在评估OSA患者的心血管风险时相比TST90%,TST80%的附加临床价值有限。