CAJ | 학술논문

目的调查高血压人群的睡眠呼吸暂停低通气综合征( OSAHS)的患病情况及肥胖对其检出的影响.方法对2009年4月1日至6月30日以高血压为主诉就诊于新疆维吾尔自治区人民医院高血压专科的住院患者,经病史询问存在睡眠时打鼾、白天嗜睡伴或不伴颈部粗短、下颌短小、舌肥大、无法解释的口舌发绀的疑似OSAHS患者,均行多导睡眠监测(PSG).定义阻塞性睡眠呼吸暂停低通气指数( AHI)≥5次/h且伴有临床症状诊断为OSAHS.结果 (1)住院高血压患者中OSAHS检出率为23.52％( 178/825)；男性患者的OSAHS检出率为34.34％( 148/431),女性为11.68％ (46/394).(2)以体质指数(BMI)为标准分组,正常组、超重组和肥胖组的OSAHS检出率分别为6.6％ (12/183)、22.22％ (78/351)和36.75％( 104/283),组间差异有统计学意义(x2=56.736,P＜0.01)；肥胖组的重度OSAHS的比例16.61％ (47/283)高于体质量正常组和超重组的2.19％ (4/183)和7.69％ (27/351),差异有统计学意义(x2=29.219,P＜0.01).(3)以腰围为标准分组,正常腰围组和中心性肥胖组的OSAHS检出率分别是7.83％ (9/115)和26.29％ (184/700),差异有显著统计学意义(x2=18.623,P＜0.01);中心性肥胖患者的重度OSAHS占10.57％( 74/700),正常腰围者为2.61％(3/115),差异有显著统计学意义(x2=7.32,P＜0.01).(4)性别分层后,女性患者中BMI高的患者,中重度OSAHS患者的检出率增高,差异有统计学意义(x2=5.846,P＜0.05)；在男性患者中BMI和腰围大者,中重度OSAHS的检出率高,差异均有显著统计学意义(P＜0.01).结论高血压人群中OSAHS的检出率较高,肥胖可能是影响OSAHS检出率的重要因素.
목적 조사고혈압인군적수면호흡잠정저통기종합정( OSAHS)적환병정황급비반대기검출적영향.방법 대2009년4월1일지6월30일이고혈압위주소취진우신강유오이자치구인민의원고혈압전과적주원환자,경병사순문존재수면시타한、백천기수반혹불반경부조단、하합단소、설비대、무법해석적구설발감적의사OSAHS환자,균행다도수면감측(PSG).정의조새성수면호흡잠정저통기지수( AHI)≥5차/h차반유림상증상진단위OSAHS.결과 (1)주원고혈압환자중OSAHS검출솔위23.52％( 178/825)；남성환자적OSAHS검출솔위34.34％( 148/431),녀성위11.68％ (46/394).(2)이체질지수(BMI)위표준분조,정상조、초중조화비반조적OSAHS검출솔분별위6.6％ (12/183)、22.22％ (78/351)화36.75％( 104/283),조간차이유통계학의의(x2=56.736,P＜0.01)；비반조적중도OSAHS적비례16.61％ (47/283)고우체질량정상조화초중조적2.19％ (4/183)화7.69％ (27/351),차이유통계학의의(x2=29.219,P＜0.01).(3)이요위위표준분조,정상요위조화중심성비반조적OSAHS검출솔분별시7.83％ (9/115)화26.29％ (184/700),차이유현저통계학의의(x2=18.623,P＜0.01);중심성비반환자적중도OSAHS점10.57％( 74/700),정상요위자위2.61％(3/115),차이유현저통계학의의(x2=7.32,P＜0.01).(4)성별분층후,녀성환자중BMI고적환자,중중도OSAHS환자적검출솔증고,차이유통계학의의(x2=5.846,P＜0.05)；재남성환자중BMI화요위대자,중중도OSAHS적검출솔고,차이균유현저통계학의의(P＜0.01).결론 고혈압인군중OSAHS적검출솔교고,비반가능시영향OSAHS검출솔적중요인소.
Objective To investigate the impact of obesity on incidence of obstructive sleep apneahypopnea syndrome(OSAHS) in hospitalized hypertensive patients.Methods A total of 825 hospitalized hypertensive patients from April 1 to June 30 in 2009 in our hospital were included.Patients were asked to answer the questions concerning snoring,daytime sleepiness. Patients with loud snoring and daytime sleepiness,tubbiness neck,retrognathia,enlarged tongue,orolingual cyanosis were selected to undergo polysomnography monitoring for a whole night.OSAHS is defined by clinical symptoms and apnea-hypopnea index (AHI) not less than 5 per hour.Results (1) The detection rate of OSAHS in this cohort was 23.52％ (178/825),34.34％ ( 148/431 ) in males and 11.68％ (46/394) in females respectively.(2) The detection rate was 6.6％ (12/183) in normal weight subjects,22.22％ (78/351) in overweight subjects and 36.75％ (104/283) in obesity subjects ( x2 =56.736,P ＜0.01 ).The severe OSAHS rate in obesity group ( 16.61％ ) was significantly higher than that in normal weight group (2.19％ ) and overweight group (7.69％,x2 =29.219,P＜0.01). (3) The OSAHS rate was 7.83％ (9/115) in normal waist circumference group and 26.29％ (184/700) in centricity obesity group ( x2 =18.623,P ＜ 0.01 ).The severe OSAHS rate was 2.61％ (3/115) in normal waist circumference group and 10.57％ (74/700) in centricity obesity (x2 =7.32,P ＜0.01 ).(4) The moderate to severe OSAHS rate increased in proportion with BMI increase in female patients ( x2 =5.846,P ＜ 0.05) and increased in proportion with BMI and waist circumference increase in male patients ( P ＜ 0.01 ).Conclusions The incidence of OSAHS in hypertensive patients is high.Obesity further increases the morbidity of OSAHS in hypertensive patients.