卢湾区30岁以上就诊病人阻塞性睡眠呼吸暂停低通气综合征患病率调查和干预

The Investigation and Interference of Obstructive Sleep Apnea-hypopnea Syndrome (OSAHS) in adults over 30 year in Luwan district in Shanghai

目的调查卢湾区30岁以上社区医疗中心就诊病人阻塞性睡眠呼吸暂停低通气综合征的患病率。方法按照随机整群抽样法,对卢湾区二个社区医疗中心30岁以上就诊的2019个病人,进行问卷调查。结果调查的2000名中,不打鼾者879名(43.95%),轻度打鼾者691名(34.55%),中度299名(14.95%),重度131名(6.55%)。不同职业组间比较差异无显著性意义。吸烟和饮酒与打鼾相关。并对25例中、重度睡眠呼吸暂停患者给予治疗,22例进行CPAP治疗,有20例治疗后疗效显著。结论卢湾区3O岁以上社区医疗中心就诊病人中OSAHS患病率为3.66%,中、重度睡眠呼吸暂停患者可给予手术治疗或进行CPAP治疗,均可获得一定疗效,OSAHS是严重危害广大人民群众健康的疾病之一,需要进一步搞好宣传教育工作。

Objective By investigating the morbidity of obstructive sleep apnea hypopnea syndrome （OSAHS） in adults aged over 30 year in Luwan district in Shanghai, to provide data for estimating the burden of this disease and making strategies for treatment and prevention of this disorder. Methods 2019 subjects （ aged ≥30 year） were derived from a random sample of the population living in two medical centers, in Luwan district in Shanghai. They were asked to answer the questions from a questionnaire concerning snoring, daytime sleepiness, and habits such as smoking and drinking, etc. According to the degree of snoring, 100 moderate and severe snorers were selected to be tested by portable PSG whole night data. The prevalence of OSAHS was conservatively estimated from the result. Results The prevalence of never snoring was 879 （ 43.95% ）, wild ones 691 （ 34. 55% ） , moderate ones 299 （ 14.95% ） , and severe ones 131 （6. 55 % ）. Smoking was associated with the severity of snoring. Among 2000 snorers, 1117 ones（55. 85 % ） believe that the snore is not illness; While 578 ones（28.9% ） believe that it need not treat; where,as 294 ones（ 14.7% ） thought it should be treated; and only 11 ones（0. 55% ） had been treated. ESS was significantly different among snorers with various severities. When AHI≥5 was taken as the cutpoint, the prevalence of 0SAHS was 18.49%. After excessive daytime sleepiness （Epworth） definited as ESS≥9 was added as a criteri- on. the conservatively estimated prevalence of 0SAHS was 3.66%. 22 moderate to severe OSAHS patients were treated by CPAP and the snores of 20 patients were relieved. Conclusions The estimated prevalence of OSAHS in adults over 30 year old was 3.66% in Luwan district in Shanghai. The moderate to severe OSAHS patients treated by surgery treatment or CPAP treatment can obtain some curative effect. This can be a great burden to public health and implies that the disease needs better understanding and study.