老年代谢综合征合并阻塞性睡眠呼吸暂停综合征的临床分析

The interaction of obstructive sleep apnoea with the metabolic syndrome in elderly patients

目的探讨老年人群代谢综合征（MS）合并阻塞性睡眠呼吸暂停综合征（OSAHS）的患病情况，分析各组别之间的相关性。方法对我院老年科诊断为MS的患者进行日间嗜睡情况调查和多导睡眠监测，调查OSAHS的患病率；将MS患者分为四组：非OSAHS组、轻度OSAHS组、中度OSAHS组和重度OSAHS组，比较不同程度OSAHS组的体重、腰围和BMI情况；对患者的夜间睡眠呼吸紊乱和体重、腰围、BMI做相关性分析；比较不同程度OSAHS患者的MS的组构成差异；分析OSAHS的严重程度与MS组的相关性。结果（1）64例符合MS诊断标准，55例完成多导睡眠图（PSG），其中49例（89．1％）诊断为OSAHS；（2）非OSAHS组的腰围、BMI和体重显著低于重度OSAHS组ESS评分显著低于中度OSAHS和重度OSAHS组；（3）Z综合征患者呼吸暂停低通气指数（AHI）及氧减饱和指数（ODI）均与腰围和BMI呈正相关，最低氧饱和度（LSaO2）与BMI呈负相关；（4）四组患者MS各组构成比无明显差异，但OSAHS随MS组增多存在加重趋势。结论老年MS人群中OSAHS患病率极高，OSAHS随腰围和BMI的升高而加重。符合MS诊断较多组的患者，OSAHS的严重程度也较高。

Objective To investigate the prevalence of OSAHS in elderly patients with metabolic syndrome in a teaching hospital and analyze the correlations of severity of OSAHS and components of MS. Method Patients （ age ≥60 years） recruited for this study had to satisfy the MS criteria of IDF. They underwent ESS and polysomnography. OSAHS was deemed to be present if AHI≥5/h. The patients were divided into 4 groups ： no-apnea, mild, moderate, and severe groups. BMI, weight and waist circumference （WC） were compared in these 4 groups. The incidences of each component in patients with MS were compared in patient with syndrome Z. Correlations were analyzed among polysomnography parameters, BMI, weight and WC. Correlations were also analyzed amongseverity of OSAHS and components of MS. Result （ 1 ） The prevelance of OSAHS was 89.1% with meanAHI of 25.4 ± 18.2/h. （2） WC and BMI of no apnea group were significantly lower. BMI and ESS were lower in both no-apnea group and mild group. （3）AHI and ODI were positively correlated with WC and BMI. LSaO2 was negetively correlated with BMI. The constituent ratios of components in MS had no statistic difference among mild, moderate, and severe OSAHS patients. However, number of MS components had positive correlation with degrees of OSAHS. Conclusion The prevalence of OSAHS was very high in elderly patients of MS. No certain component of MS influenced the development of OSAHS,but patients who had more components of MS also had more serious OSAHS.