CAJ | 학술논문

目的调查阻塞性睡眠呼吸暂停患者接受持续气道正压通气压力滴定时复杂性睡眠呼吸暂停综合征的发生率及其多导睡眠监测的特点.方法回顾性分析2010年1月至2012年12月在四川大学华西医院睡眠医学中心诊断为阻塞性睡眠呼吸暂停并接受整夜持续气道正压通气压力滴定的420例成年患者的临床资料,分析其多导睡眠监测记录,对呼吸事件、氧减事件、睡眠分期数据进行对比分析.结果复杂性睡眠呼吸暂停综合征的发生率为7.9％ (33/420),中枢性呼吸暂停指数为(9.0±5.1)次/h.复杂性睡眠呼吸暂停与非复杂性睡眠呼吸暂停患者在年龄、性别、体质指数及持续气道正压通气滴定压力上差异均无统计学意义(均P＞0.05).与非复杂性睡眠呼吸暂停患者相比,复杂性睡眠呼吸暂停患者中位呼吸暂停低通气指数(12.8比3.6次/h)、氧减指数(10.3比3.8次/h)均显著增高(均P＜0.05),且以非快速眼动期增高为主.复杂性睡眠呼吸暂停患者的总睡眠时间[(365 ±96)比(402±77)min]及快速眼动期比例(16％±8％比20％±10％)显著减少,但入睡后觉醒时间[(108±93)比(79±61) min)]、非快速眼动1期睡眠比例(24％±17％比15％±13％)以及微觉醒指数[(28±15)比(20±12)次/h]均显著增高(均P＜0.05).结论阻塞性睡眠呼吸暂停患者持续气道正压通气治疗中复杂性睡眠呼吸暂停的发生率并不低,患者睡眠时间和质量均降低.
목적 조사조새성수면호흡잠정환자접수지속기도정압통기압력적정시복잡성수면호흡잠정종합정적발생솔급기다도수면감측적특점.방법 회고성분석2010년1월지2012년12월재사천대학화서의원수면의학중심진단위조새성수면호흡잠정병접수정야지속기도정압통기압력적정적420례성년환자적림상자료,분석기다도수면감측기록,대호흡사건、양감사건、수면분기수거진행대비분석.결과 복잡성수면호흡잠정종합정적발생솔위7.9％ (33/420),중추성호흡잠정지수위(9.0±5.1)차/h.복잡성수면호흡잠정여비복잡성수면호흡잠정환자재년령、성별、체질지수급지속기도정압통기적정압력상차이균무통계학의의(균P＞0.05).여비복잡성수면호흡잠정환자상비,복잡성수면호흡잠정환자중위호흡잠정저통기지수(12.8비3.6차/h)、양감지수(10.3비3.8차/h)균현저증고(균P＜0.05),차이비쾌속안동기증고위주.복잡성수면호흡잠정환자적총수면시간[(365 ±96)비(402±77)min]급쾌속안동기비례(16％±8％비20％±10％)현저감소,단입수후각성시간[(108±93)비(79±61) min)]、비쾌속안동1기수면비례(24％±17％비15％±13％)이급미각성지수[(28±15)비(20±12)차/h]균현저증고(균P＜0.05).결론 조새성수면호흡잠정환자지속기도정압통기치료중복잡성수면호흡잠정적발생솔병불저,환자수면시간화질량균강저.
Objective To explore the occurrence of complex sleep apnea syndrome in patients with obstructive sleep apnea during continuous positive airway pressure titration and evaluate their polysomnographic characteristics.Methods A total of 420 patients with obstructive sleep apnea were recruited to undergo an overnight continuous positive airway pressure titration at the Sleep Medicine Center,West China Hospital from January 2010 to December 2012.Their polysomnographic records of respiratory events,oxygen desaturation events and sleep stages were retrospectively reviewed.Results The incidence of complex sleep apnea syndrome was 7.9％ (33/420) and central apnea index (9.0 ±5.1)/h.No significant differences existed in age,gender,body mass index and titration pressure of continuous positive airway pressure between two groups.Compared with those with non-complex sleep apnea,complex sleep apnea patients had significant increases in apnea/hypopnea index (12.8/h vs 3.6/h,P ＜ 0.05) and oxygen desaturation index (10.3/h vs 3.8/h,P ＜ 0.05) which mainly happened in non-rapid eye movement stage.They also showed decreases in total sleep time ((365 ± 96) vs (402 ± 77) min),rapid eye movement stage (16％ ±8％ vs20％ ±10％),increases in non-rapid eye movement stage 1 (24％ ±17％ vs 15％ ±13 ％),wakefulness after sleep onset ((108 ± 93) vs (79 ± 61) min) and brief arousal index ((28 ± 15) vs (20 ± 12)/h).And the differences were statistically significant (all P ＜ 0.05).Conclusions Complex sleep apnea syndrome is common among Chinese patients with obstructive sleep apnea.Compared with those with non-complex sleep apnea,complex sleep apnea patients have reduced sleep time and worse sleep quality during continuous positive airway pressure therapy.