上海市30岁以上女性鼾症的患病率及危险因素分析

ANALYSIS ON THE PREVALENCE OF SNORING AND ASSOCIATED RISK FACTORS IN WOMEN AGED OVER 30 IN SHANGHAI

[目的]研究我国成年女性鼾症患病状况和相关危险因素。[方法]资料来自上海市30岁以上居民睡眠呼吸暂停流行病学调查,有BMI记录的女性2938名,其中完整记录月经状态者2423例。分别以BMI和月经状态进行分组,应用Logistic回归等统计学方法分析年龄、吸烟、饮酒以及家族史等因素对人群鼾症患病影响的相对危险度。[结果]中国成年女性人群中重度鼾症患病率15%,且随着年龄增加,60～69岁达高峰。月经规律组,以20～25kg/m2为参照类,随BMI增加相对危险度逐渐增加,25kg/m2以上和30kg/m2以上OR值分别为3.906和8.467(P﹤0.001)。而BMI低于20kg/m2者则OR值仅为0.328(P﹤0.05)。绝经后危险因素以BMI和家族史,以及饮酒为主,且随BMI增加相对危险度提高。同样以20～25kg/m2为参照类,BMI25kg/m2和30kg/m2以上OR值分别为2.041(P﹤0.001)和2.884(P﹤0.01)。依据BMI分组,则显示BMI﹤20kg/m2者主要危险因素为绝经(OR=10.568,P﹤0.05)。BMI20-25kg/m2者,主要危险因素包括绝经、家族史以及饮酒等。BMI25～30kg/m2的女性独立危险因素为家族史。[结论]中国女性人群中重度打鼾患病率达15%。其发生与BMI、绝经以及饮酒和家族史有关。因此女性保持一定的雌激素水平,减肥、戒酒是预防和治疗鼾症的主要策略,特别是有家族史者。

[ Objective] To investigate the prevalence of snoring and analyze the associated risk factors in women. [ Methods] An epidemiologic study was performed by using a questionnaire and 2 938 women aged over 30 were analyzed. [ Results] The prevalence of moderate and severe snoring of Chinese women was 15%. which increased with the age and the highest prevalence occurred between ages of 60-69 years. Among those with the regular menstruation. BMI was the main risk factor. Compared with 20-25 kg/m^2, OR was 3.906 （ BMI≥25 kg/m^2, P 〈 0.001 ） and 8.467 （BMI ≥ 30 kg/m^2. P 〈 0.001 ） respectively. The snoring of women in the menopause was related with BMI, family history and drinking. Compared with 20-25 kg/m^2, OR was 2.041 （ BMI≥25 kg/m^2, P〈 0.001） and 2.884 （BMI≥30 kg/m^2. P〈 0.01） respectively. According to the different values of BMI in groups, the resuhs showed the only risk factor was menopause in women with the value of BMI under 20kg/m^2 （ OR =10.568, P 〈 0.05）. In women with the value of BMI between 20-25 kg/m^2, main risk factors included menopause, family history and drinking, etc. [Conclusion] There is also a high prevalence of moderate and severe snoring in Chinese women. No matter how the BMI is, menopause is the main risk factor, and familv history and drinking contribute to snoring partially. Women should remain the suitable level of estrogen. Reducing weight and stopping drinking are the main strategies to cure snoring, especially for women with family histories.