阻塞性睡眠呼吸暂停低通气综合征患者夜间缺氧程度的评估

The evaluation of the severity of nocturnal oxygen desaturation of patients with obstructive sleep apnea hypopnea syndrome

目的评估阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的夜间缺氧程度。方法对疑诊有睡眠呼吸障碍的患者215例进行夜间睡眠呼吸监测,计算平均血氧饱和度(AO_2)、最低血氧饱和度(LO_2)、氧减指数(ODI)、平均氧减饱和度、血氧饱和度低于90%占整个记录时间的百分比(T<90%),并进行相关分析。结果依据所有患者的呼吸暂停低通气指数(AHI)分为 AHI 正常组(AHI<5次/h)、轻度 OSAHS 组(5次/h≤AHI<15次/h)、中度 OSAHS 组(15次/h≤AHI<30次/h)、重度 OSAHS 组(AHI≥30次/h),4组 AO_2、LO_2、ODI、T<90%差异有统计学意义(P<0.001)。AHI 与 AO_2、ODI、LO_2、平均氧减饱和度、T<90%显著相关(r 分别为-0.610、0.983、-0.789、0.782、0.821,P=0.001)。结论 OSAHS 患者缺氧严重程度的评估需结合 ODI、LO_2、T<90%三个指标综合判断,不能仅考虑单一指标。

Objective Oxygen desaturation is common among patients with sleep apnea. This study was designed to evaluate the methods used to express the severity of oxygen desaturation in patients with obstructive sleep apnea hypopnea syndrome. Methods The oxygen saturation data of 215 patients[ suspected of having obstructive sleep apnea （ OSA ） ] studied at the Sleep Centre of Peking Union Medical College Hospital were evaluated. Apnea-hypopnea index （AHI） and the following conventional indices of oxygen desaturation were compared： average oxygen saturation （ AO2 ） , lowest oxygen saturation （ LO2 ）, oxygen desaturation index（ODI） ,average desaturation and the percent of the total time with oxygen saturation level lower than 90% （ T 〈 90% ）. Results There was a significant correlation between the oxygen saturation values measured by any method （ AO2, LO2, ODI, average desaturation, T 〈 90% ） and the severity of sleep AHI（r = -0. 610,0. 983, -0. 789,0. 782,0. 821 ,respectively,P =0. 001 ）. Conclusions The best method of expressing the severity of oxygen desaturation in patients with obstructive sleep apnea hypopnea syndrome needs the combination of several conventional indices of oxygen desaturation （lowest oxygen saturation, oxygen desaturation index, and the percent of the total time with oxygen saturation level lower than 90% ）.