CAJ | 학술논문

目的：探究男性睡眠呼吸暂停低通气综合征（ OSAHS）患者性激素水平的改变，并分析影响性激素水平的关键因素。方法收集2014年3月—2015年3月就诊的男性OSAHS患者85例（ OSAHS组）的一般资料及临床资料。所有患者均行多导睡眠监测，记录快速动眼睡眠（ REM）在整个睡眠时间中所占比（ REM％）、呼吸暂停低通气指数（ AHI）、最低动脉血氧饱和度（ LSaO2）及平均动脉血氧饱和度（ MSaO2）及Epworth嗜睡量表评分（ ESS），同时搜集20例年龄匹配的健康男性体检者作为健康对照组。比较2组性激素水平的差异，并运用多元线性回归模型分析年龄、BMI、REM％、AHI、LSaO2、MSaO2及ESS 与性激素之间的相关性。结果 OSAHS组BMI明显高于健康对照组（P ＜0±．01），TT与E2均明显低于健康对照组（ P ＜0．01），消除BMI可能对激素水平的影响后，OSAHS组TT仍明显高于健康对照组（ P ＜0．01），而E2在2组之间的差异不复存在（ P ＞0．05）。多元线性回归分析发现，患者年龄与E2呈显著负相关（β＝－0．37， P ＜0．01）；MSaO2与TT （β＝0．31， P ＝0．02）及E2（β＝0．93， P ＜0．01）均呈显著正相关，其他指标与TT及E2之间无明显相关性。结论 OSAHS男性患者TT及E2水平明显低于正常人群，E2的降低可能与肥胖有关，而TT的降低可能是OSAHS本身，或者OSAHS与肥胖的协同作用导致的。 E2水平随着年龄的增长而降低；E2与TT浓度也均随着缺氧程度的加重而降低。
목적：탐구남성수면호흡잠정저통기종합정（ OSAHS）환자성격소수평적개변，병분석영향성격소수평적관건인소。방법수집2014년3월—2015년3월취진적남성OSAHS환자85례（ OSAHS조）적일반자료급림상자료。소유환자균행다도수면감측，기록쾌속동안수면（ REM）재정개수면시간중소점비（ REM％）、호흡잠정저통기지수（ AHI）、최저동맥혈양포화도（ LSaO2）급평균동맥혈양포화도（ MSaO2）급Epworth기수량표평분（ ESS），동시수집20례년령필배적건강남성체검자작위건강대조조。비교2조성격소수평적차이，병운용다원선성회귀모형분석년령、BMI、REM％、AHI、LSaO2、MSaO2급ESS 여성격소지간적상관성。결과 OSAHS조BMI명현고우건강대조조（P ＜0±．01），TT여E2균명현저우건강대조조（ P ＜0．01），소제BMI가능대격소수평적영향후，OSAHS조TT잉명현고우건강대조조（ P ＜0．01），이E2재2조지간적차이불복존재（ P ＞0．05）。다원선성회귀분석발현，환자년령여E2정현저부상관（β＝－0．37， P ＜0．01）；MSaO2여TT （β＝0．31， P ＝0．02）급E2（β＝0．93， P ＜0．01）균정현저정상관，기타지표여TT급E2지간무명현상관성。결론 OSAHS남성환자TT급E2수평명현저우정상인군，E2적강저가능여비반유관，이TT적강저가능시OSAHS본신，혹자OSAHS여비반적협동작용도치적。 E2수평수착년령적증장이강저；E2여TT농도야균수착결양정도적가중이강저。
Objective To explore the changes of sex hormone levels in male patients with obstructive sleep apnea hy -popnea syndrome ( OSAHS) and to analyze the key factors of affecting sex hormone levels .Methods General information and clinical data of 85 male OSAHS patients ( OSAHS group ) who were treated from March 2014 to March 2015 were collected . All patients underwent multichannel monitoring of sleep , and rapid eye movement ( REM) sleep in total sleep time ’ s ratio (REM%), apnea saturation (MSaO2) and average artery of hypopnea index (AHI), minimum arterial oxygen saturation (LSaO2) of the oxygen and Epworth Sleepiness Scale (ESS) were recorded, we collected 20 cases of age matched healthy male subjects as healthy control group .Differences of sex hormone levels were compared between the two groups , and the use of multiple linear regression model to analyze the correlation between age , BMI, REM%, AHI, LSaO2 , MSaO2 and ESS and sex hormone.Results BMI of OSAHS group was significantly higher than those in healthy control group ( P <0.01), TT and E2 were significantly lower than healthy control group ( P <0.01), eliminated BMI potential effect on the hormone lev-els, TT in OSAHS group was still significantly higher than those in healthy control group ( P <0.01), and E2 differences be-tween the 2 groups were disappeared ( P >0.05).Multiple linear regression analysis showed that , age of patients and E2 showed significant negative correlation (β=-0.37, P <0.01);MSaO2 and TT (β=0.31, P =0.02) and E2 (β=0.93, P <0.01) showed a significant positive correlation , and other indicators of TT and E2 had no clear relationship.Conclusion OSAHS male patients’ TT and E2 levels were significantly lower than the normal population , E2’s reduction may be associated with obesity, and TT’s reduce maybe due to OSAHS itself, or OSAHS and synergistic effect of obesity .E2 levels’ decreased along with age increasing;E2 and TT levels were decreased with increasing the degree of hypoxia .