Chollet S, Ordronneau J, Chailleux E, Nogues B, Canfrère I, Hervouet A
USI de Pneumologie, Hôpital G. et R. Laënnec, Nantes.
Rev Mal Respir. 1993;10(6):519-25.
A retrospective study was carried out on 347 case notes involving 303 men and 44 women who were suffering from a sleep apnea syndrome (SAS). The mean age was 57 plus or minus 10 years, and the diagnosis was made between 1982 and 1992. We have carried out the research to examine if there were clinical factors or factors related to respiratory function which would predict the acceptance in the short or long term and the correct observation in a daily time-table of nocturnal continuous positive pressure (PPC). The diagnosis of SAS was made using conventional polygraphy (35%), computerised cardiorespiratory recording 38%, or limited to transcutaneous saturation 27%. The mean number of respiratory nocturnal events in the three groups were respectively 48 plus or minus 25 per hour during sleep, and 45 plus or minus 23 and 51 plus or minus 20 per hour by the recording techniques. We have suggested a treatment by PPC in 235 patients: 86 patients refused at the outset (37%), 26 stopped secondarily (11%), and 108 (46%) continued until the end point 1992 with a mean duration of treatment of 24 (plus or minus 17), months and a mean duration of nocturnal usage of 6.2 (plus or minus 2.5) hours a mean level of positive pressure of 11 (plus or minus) 2) centimetres. The primary acceptance of PPC is significantly linked to the understanding of the patient of the functional signs (p less than 0.001) and of the severity of diurnal hypersomnolence (p less than 0.001). The acceptance in the long-term is linked in a weakly significant manner to the recognition by the patient of functional signs (p less than 0.04). None of the other 68 criteria used for assessing the severity of the patient and the SAS had any influence on the acceptance of PPC in short or long term. The compliance with a daily time-table is a weakly significant factor to the severity of the SAS judged by the number of nocturnal respiratory events (p less than 0.03).
对347份病例记录进行了一项回顾性研究，这些病例涉及303名男性和44名女性，他们都患有睡眠呼吸暂停综合征（SAS）。平均年龄为57岁加减10岁，诊断时间在1982年至1992年之间。我们开展这项研究是为了检查是否存在临床因素或与呼吸功能相关的因素，这些因素能够预测短期或长期对夜间持续气道正压通气（PPC）的接受情况以及在日常时间表中的正确观察情况。SAS的诊断采用传统多导睡眠监测（35%）、计算机化心肺记录（38%）或仅限于经皮血氧饱和度监测（27%）。三组患者夜间呼吸事件的平均数量分别为睡眠期间每小时48次加减25次，以及通过记录技术测得的每小时45次加减23次和51次加减20次。我们建议对235名患者采用PPC治疗：86名患者一开始就拒绝（37%），26名患者后来停止（11%），108名患者（占46%）持续到1992年的终点，平均治疗持续时间为24（加减17）个月，夜间平均使用时间为6.2（加减2.5）小时，平均正压水平为11（加减2）厘米水柱。PPC的初始接受情况与患者对功能体征的理解（p<0.001）和日间过度嗜睡的严重程度（p<0.001）显著相关。长期接受情况与患者对功能体征的认识呈弱显著相关（p<0.04）。用于评估患者严重程度和SAS的其他68项标准中，没有一项对短期或长期接受PPC有任何影响。按照日常时间表的依从性是根据夜间呼吸事件数量判断的SAS严重程度的一个弱显著因素（p<0.03）。
