CAJ | 학술논문

目的：探讨新疆不同民族阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的临床表现和治疗措施。方法对566例新疆不同民族 OSAHS 患者进行睡眠打鼾与憋气问卷调查、头颈部测量以及夜间多导睡眠监测（PSG），并对资料进行分类统计。结果 OSAHS 患者中汉族占68．55％，维吾尔族占21．38％，其他民族较少。男、女性 OSAHS 患者睡眠打鼾、白天嗜睡、夜间憋醒、咽喉腔狭小、高血压、打鼾家族史、肥胖、醒后血压升高和红细胞数增多有统计学意义（P ＜0．05）。多因素 Logistic 回归分析结果显示，对睡眠打鼾进入方程的影响因素有白天嗜睡、夜间憋醒、咽喉腔狭小和肥胖（P ＜0．05），不同年龄和民族影响因素差异无统计学意义（P ＞0．05）。不同性别 OSAHS 患者多因素 Logistic 回归分析结果显示，男、女性患者白天嗜睡、夜间憋醒、咽喉腔狭小、肥胖和高血压差异有统计学意义（P ＜0．05），高血脂差异无统计学意义（P ＞0．05）。早醒后血压增高、红细胞增多和肺部病变差异有统计学意义（P ＜0．05），记忆力减退、胸部烧痛、冠心病、心律失常、肾功能不全和脑血管意外差异无统计学意义（P ＞0．05）。男、女性患者悬雍垂肥大、口咽腔狭小、扁桃体Ⅲ度肿大、下颌小后缩、腺样体肥大、舌体肥大差异有统计学意义（P ＜0．05），而颈部短粗和软腭底增厚差异无统计学意义（P ＞0．05）。不同年龄患者治疗方法的差异均有统计学意义（P ＜0．05），进一步进行 Logistic 回归分析结果显示，男、女性扁桃体增殖体刮除术、扁桃体摘除术、增殖体摘除术、气管切开术和气道正压通气治疗差异均有统计学意义（P ＜0．05），而悬雍垂体腭咽成形术和鼻中隔矫正术治疗差异无统计学意义（P ＞0．05）。结论新疆 OSAHS 患者中汉族多于维吾尔族，其余民族中发病率较低，高血压和肥胖是该病的主要危险因素。应根据 OSAHS 患者的病情以及年龄和性别选择适宜的临床治疗方法。目的：探討新疆不同民族阻塞性睡眠呼吸暫停低通氣綜閤徵（OSAHS）患者的臨床錶現和治療措施。方法對566例新疆不同民族 OSAHS 患者進行睡眠打鼾與憋氣問捲調查、頭頸部測量以及夜間多導睡眠鑑測（PSG），併對資料進行分類統計。結果 OSAHS 患者中漢族佔68．55％，維吾爾族佔21．38％，其他民族較少。男、女性 OSAHS 患者睡眠打鼾、白天嗜睡、夜間憋醒、嚥喉腔狹小、高血壓、打鼾傢族史、肥胖、醒後血壓升高和紅細胞數增多有統計學意義（P ＜0．05）。多因素 Logistic 迴歸分析結果顯示，對睡眠打鼾進入方程的影響因素有白天嗜睡、夜間憋醒、嚥喉腔狹小和肥胖（P ＜0．05），不同年齡和民族影響因素差異無統計學意義（P ＞0．05）。不同性彆 OSAHS 患者多因素 Logistic 迴歸分析結果顯示，男、女性患者白天嗜睡、夜間憋醒、嚥喉腔狹小、肥胖和高血壓差異有統計學意義（P ＜0．05），高血脂差異無統計學意義（P ＞0．05）。早醒後血壓增高、紅細胞增多和肺部病變差異有統計學意義（P ＜0．05），記憶力減退、胸部燒痛、冠心病、心律失常、腎功能不全和腦血管意外差異無統計學意義（P ＞0．05）。男、女性患者懸雍垂肥大、口嚥腔狹小、扁桃體Ⅲ度腫大、下頜小後縮、腺樣體肥大、舌體肥大差異有統計學意義（P ＜0．05），而頸部短粗和軟腭底增厚差異無統計學意義（P ＞0．05）。不同年齡患者治療方法的差異均有統計學意義（P ＜0．05），進一步進行 Logistic 迴歸分析結果顯示，男、女性扁桃體增殖體颳除術、扁桃體摘除術、增殖體摘除術、氣管切開術和氣道正壓通氣治療差異均有統計學意義（P ＜0．05），而懸雍垂體腭嚥成形術和鼻中隔矯正術治療差異無統計學意義（P ＞0．05）。結論新疆 OSAHS 患者中漢族多于維吾爾族，其餘民族中髮病率較低，高血壓和肥胖是該病的主要危險因素。應根據 OSAHS 患者的病情以及年齡和性彆選擇適宜的臨床治療方法。
목적：탐토신강불동민족조새성수면호흡잠정저통기종합정（OSAHS）환자적림상표현화치료조시。방법대566례신강불동민족 OSAHS 환자진행수면타한여별기문권조사、두경부측량이급야간다도수면감측（PSG），병대자료진행분류통계。결과 OSAHS 환자중한족점68．55％，유오이족점21．38％，기타민족교소。남、녀성 OSAHS 환자수면타한、백천기수、야간별성、인후강협소、고혈압、타한가족사、비반、성후혈압승고화홍세포수증다유통계학의의（P ＜0．05）。다인소 Logistic 회귀분석결과현시，대수면타한진입방정적영향인소유백천기수、야간별성、인후강협소화비반（P ＜0．05），불동년령화민족영향인소차이무통계학의의（P ＞0．05）。불동성별 OSAHS 환자다인소 Logistic 회귀분석결과현시，남、녀성환자백천기수、야간별성、인후강협소、비반화고혈압차이유통계학의의（P ＜0．05），고혈지차이무통계학의의（P ＞0．05）。조성후혈압증고、홍세포증다화폐부병변차이유통계학의의（P ＜0．05），기억력감퇴、흉부소통、관심병、심률실상、신공능불전화뇌혈관의외차이무통계학의의（P ＞0．05）。남、녀성환자현옹수비대、구인강협소、편도체Ⅲ도종대、하합소후축、선양체비대、설체비대차이유통계학의의（P ＜0．05），이경부단조화연악저증후차이무통계학의의（P ＞0．05）。불동년령환자치료방법적차이균유통계학의의（P ＜0．05），진일보진행 Logistic 회귀분석결과현시，남、녀성편도체증식체괄제술、편도체적제술、증식체적제술、기관절개술화기도정압통기치료차이균유통계학의의（P ＜0．05），이현옹수체악인성형술화비중격교정술치료차이무통계학의의（P ＞0．05）。결론신강 OSAHS 환자중한족다우유오이족，기여민족중발병솔교저，고혈압화비반시해병적주요위험인소。응근거 OSAHS 환자적병정이급년령화성별선택괄의적림상치료방법。
Objective To explore the clinical manifestations and treatment measures of different racial pa-tients with Obstructive sleep apnea hypopnea syndrome (OSAHS)in Xinjiang.Methods 566 cases of OS-AHS patients of different nationalities in Xinjiang were measured in terms of snoring,breathe,head and neck measurement and nocturnal polysomnography (PSG)to retrospectively analyze and the classify the data.Results OSAHS patients Han accounted for 68.55%,Uyghur for 21.38%,other minorities were rare.The chi square test results show that the snoring,daytime sleepiness,night awakenings,narrow throat cavity,hypertension,family history of obesity,elevated blood pressure,snoring wake-up and the number of red blood cells increased with statistical significance in male and female OSAHS patients (P <0.05).Further regression analysis showed that the multi factor Logistic,a daytime sleepiness,snoring on influence factors into the equation of the hold up at night,the throat cavity narrow and obesity had statisti-cal significance (P <0.05).Age and ethnic groups had no statistical significance (P >0.05).Gender differ-ences in OSAHS multi factor Logistic regression analysis showed that male,daytime sleepiness,night a-wakenings,narrow throat cavity,obesity and hypertension was statistically significant (P <0.05),high blood fat had no statistical significance (P > 0.05).The main complications-waking early and increased blood pressure,increased red blood cell and lung lesions was statistically significant (P <0.05);the re-maining memory loss,abdominal burning pain,coronary heart disease,arrhythmia,renal dysfunction and cerebral vascular accident project had no statistical significance (P >0.05).Analysis of variance showed hypertrophic uvula,oropharyngeal cavity narrow,tonsil Ⅲ degree swelling,small mandible retrusion,ad-enoid hypertrophy,tongue hypertrophy was significant facial and oral survey project of male and female cases (P <0.05),while the neck thick and soft palate low thickness had no statistical significance (P >0.05).Treatment of patients with different age differences were statistically significant (P <0.05),the a-nalysis of the Logistic regression results showed that the male,female body curettage,tonsil proliferation, tonsil extirpate scion excision,tracheotomy and positive airway pressure treatment differences were statis-tically significant (P <0.05),while the uvula palate pharyngoplasty and for the treatment of nasal septum correctional difference has no statistical significance (P >0.05).Conclusion OSAHS patients in Xinjiang Han nationality are higher than Uyghur,incidence rate of the rest of the nation is low,its characteristics of hypertension and obesity is a major risk factor for the disease.According to the condition of patients with OSAHS and the clinical treatment of age and sex selection is appropriate.