老年睡眠呼吸暂停低通气综合征患者临床特点分析

Clinical characteristics of elderly patients with sleep apnea-hyponea syndrome

目的探讨老年睡眠呼吸暂停低通气综合征(SAHS)临床特点。方法对273例可疑患者用多导睡眠图仪(PSG)诊断后,分析老年SAHS病人的主要临床症状、全身各系统并发症和PSG结果。结果老年SAHS中打鼾、夜间憋醒、夜间尿频、性别比、体质量指数及心脑血管、呼吸系统并发症与中青年患者比较有显著差异;而白天嗜睡、记忆力下降、失眠、颈围及内分泌系统并发症2组间无明显差别。PSG检测显示老年SAHS患者总的睡眠时间(TST)和Ⅲ、Ⅳ期占总睡眠时间的百分比及呼吸暂停低通气指数(AHI)和氧减指数明显比中青年患者低。持续气道正压通气(CPAP)治疗可明显降低老年SAHS患者的AHI和氧减指数,而对微觉醒指数和睡眠结构无明显影响。结论老年SAHS具有区别于中青年SAHS的临床特点,识别这些特点有助于早期诊断。

Objective To explore the clinical characteristics of elderly patients with sleep apnea-hypopnea syndrome （SAHS）. Methods Polysomnography（PSG） was used to confirm 273 suspectable cases of SAHS, The principal symptoms,complications and PSG results of elderly patients with SAHS were analyzed. Results Snoring, oppressive wake, nocturnal frequency of mictufition, sex difference, body mass index（BMI） and complications in elderly SAHS were significantly different from those in non-elderly SAHS patients. However, there were no significant differences in daytime sleepiness, forgetfulness,insomnia, neck circumference and endocrine system complication. PSG montior showed that total sleep time （TST） ,the percentage of stage Ⅲ sleep/TST,the pecentage of stage Ⅳ sleep/TST, apnea-hypopnea index （AHI） and 02 desaturation index were significantly lower in elderly patients compared with non-elderly ones. After continuous positive airway pressure（CPAP） therapy,there was a significant decrease in AHI and desaturation index, but not in microarousal index and sleep structure. Conclusions The elderly SAHS patients have some characteristics which are different from those of the non-elderly SAHS patients and can be useful for early diagnosis.