对比分析老年与中青年阻塞性睡眠呼吸暂停低通气综合征的临床特点

Comparison of clinical features of obstructive sleep apnea hypopnea syndrome between the elderly and the young or middle-aged

目的通过与中青年阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者比较,探讨老年OSAHS患者的临床特点。方法随机选取161例OSAHS患者,按年龄分为老年组（≥60岁,n=72）与中青年对照组（23~59岁,n=89）,对两组临床资料、睡眠多导图结果进行对比分析,并随访比较两组治疗方式的选择。结果老年OSAHS组睡眠呼吸暂停低通气指数（AHI）及最低氧饱和度、氧减饱和指数（ODI）较体质量指数相匹配的中青年组轻（P〈0.05）。老年OSAHS组的醒后收缩压高于中青年组,但其醒后舒张压、心率均低于中青年组（P〈0.05）。老年OSAHS醒后血压与AHI、ODI、微觉醒指数呈正相关。老年组选择外科手术及口腔矫治器的治疗率明显低于中青年组（P〈0.01）,而选择持续气道正压通气治疗的比例两组间差异无统计学意义（P〉0.05）。结论老年OSAHS严重程度明显较中青年组轻。AHI、反复低氧及反复微觉醒可能与老年人醒后血压升高有关。老年OSAHS外科手术及口腔矫治器选择率低于中青年组。

Objective To study the clinical features of obstructive sleep apnea hypopnea syndrome（OSAHS） in the elderly by comparison with the young or middle-aged OSAHS patients.Methods Randomly selected 161 OSAHS patients were divided into elderly group（n=72） and young or middle-aged control group（n=89）.The clinical data and polysomnographic parameters were compared between the two groups.The therapy options for the patients,followed by phone calls,were also compared between the two groups.Results The apnea hypopnea index（AHI）,the lowest oxygen saturation,and oxygen desaturation index（ODI） were significantly lower in elderly group than in body mass index-matched young or middle-aged controls（P0.05）.The systolic blood pressure was higher,but the diastolic blood pressure and heart rate were lower in elderly group than in young or middle-aged controls（P0.05）.In elderly OSAHS patients,blood pressure was positively associated with AHI,ODI,and arousal index.The acceptance of surgery and oral appliances in elderly OSAHS patients was significantly lower than that in young or middle-aged controls（P0.01）,but the acceptance of continuous positive airway pressure was not significantly different between the two groups（P0.05）.Conclusion The elderly patients suffer less severe OSAHS than young or middle-aged patients.AHI,ODI,and arousal index may be related to the increased blood pressure of elderly OSAHS.The elderly OSAHS patients have lower acceptance of surgery and oral appliances compared with young and middle-aged controls.