舌根平面阻塞对阻塞性睡眠呼吸暂停低通气综合征患者多导睡眠监测指标的影响

Effect of retrolingual obstruction on polysomonography of patients with obstructive sleep apnea hypopnea syndrome

目的探讨舌根平面阻塞对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OS-AHS)病情严重程度的影响。方法回顾分析230例OSAHS患者的上气道阻塞情况,并根据是否存在舌根平面阻塞将患者分为两组,比较年龄,体质指数(body mass index,BMI)及PSG主要监测指标。结果①230例OSAHS患者均存在不同程度的腭咽平面阻塞,其中120例存在舌根平面的阻塞,105例存在各种鼻阻塞性疾病,53例同时存在舌根平面阻塞与鼻阻塞病变。②两组患者比较,存在舌根平面阻塞者整体年龄偏大,NREMⅠ期睡眠较多,NREMⅡ期睡眠较少,呼吸暂停指数(apnea index,AI)较大,低通气指数(hypopnea index,HI)较小;而体质指数、NREMⅢ期、Ⅳ期睡眠、REM睡眠、呼吸暂停低通气指数(apnea hypopnea index,AHI)、微觉醒指数、最长呼吸紊乱事件、最低血氧饱和度两组比较无明显差异(P>0.05)。结论伴有舌根平面阻塞的患者整体年龄偏大,睡眠结构紊乱较重,呼吸事件中呼吸暂停较多,低通气较少。

Objective To evaluate the effect of retrolingual obstruction on polysomnograhy （PSG） of patients with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods 230 OSAHS patients proved as OSAHS by PSG were divided into two groups： the retrolingual obstruction group and the non-retrolingual obstruction group. Age, body mass index （BMI） and the main outcomes of PSG were compared between the two groups. Results All 230 patients had an oropharynx obstruction, of them 120 had a retrolingual obstruction, 105 had a nasal obstruction and 53 had a nasal obstruction and retrolingual obstruction. Age, percentage of time in non-rapid eye movement （NREM） sleep 1 phase and apnea index （AI） were higher in the group with retrolingual obstruction but the percentage of time in the NREM stage sleep 2 phrase and the hypopnea index （HI） were lower in the group with retrolingual obstruction than in the non-retroligual obstruction group. There were no significant differences in body mass index （BMI）, percentage of time in the NREM sleep 3 phrase, percentage of time in the NREM sleep 4 phrase, percentage o; time in the rapid eye movement （REM） sleep phrase, the apnea hypopnea index （AHI）, the lowest oxygen situation level, the longest event with apnea or hypopnea and the total microarousal index （MI） between the two groups （ P 〉0.05）. Conclusion Most OSAHS patients are old and with retrolirgual obstruction, also they have worse disturbance sleep with a high AI and a low HI.