主动脉夹层和呼吸睡眠暂停综合征的关系研究

A retrospective questionnaire analysis on the association of obstructive sleep apnea syndrome and aortic dissection

目的通过回顾性的问卷调查对主动脉夹层患者梗阻性呼吸睡眠暂停综合征（obstructive sleep apnoea syndrome，OSAS）的相关症状进行研究。方法参考Berlin问卷对夹层患者和非夹层患者进行问卷调查。回收调查问卷并对两组患者的一般资料和相关症状进行比较。我们再将对照组中合并高血压者和主动脉夹层患者的相关症状进行比较。结果一共收回70份问卷，其中夹层组33例；对照组37例。夹层组打鼾的有29例（87．88％），高于对照组的22例（59．46％）（P〈0．05）；几乎每天都打鼾的夹层组为19例（57．58％），高于对照组的12例（32．43％）（P〈0．05）；鼾声影响他人的夹层组为23例（69．70％），高于对照组的10例（27．03％）（P〈0．05）；家人注意到有呼吸暂停现象的夹层组有15例（45．45％），其中每天都有的有9例（27．27％），对照组分别为8例（21．62％）（P〈0．05）和5例（13．51％）（P〈0．05）。醒来后感觉不解乏的夹层组为23例（69．70％），几乎每天都感觉不解乏的为10例（30．30％），对照组分别为15例（40．54％）（P〈0．05）和6例（16．22％）（P〈0．05）；夹层组合并高血压的有28例（84．85％），对照组为20例（54．05％）（P〈0．05）；合并高血压的非夹层患者平均年龄（62±16）岁，较夹层组年龄大（P〈0．05）；鼾声影响他人休息的有7例（35％），明显少于夹层组（69．7％）（P〈0．05）。夹层组患者比非夹层高血压患者身高更高（P〈0．05），腰臀比更小（P〈0．05）。结论主动脉夹层患者中普遍存在OSAS症状。

Objective To investigate obstructive sleep apnea syndrome （OSAS） in patients with aortic dissection （AD）. Methods Questionnaire analysis was applied to patients with or without AD according to Berlin questionnaire. Questionnaires were collected and common characters and related symptoms were compared between the two groups. Further comparison on related symptoms was made between the AD group and hypertensive patients in the control group. Results Totally 70 questionnaires were collected with 33 for the AD group （29 males and 4 females） and 37 for the control （29 males and 8 females）. The average age （P 〈0.05） was 50. 9 years for the AD group （range 32 to 70） and 53.4 years for the control （range 25 to 83）. Snoring occurred in 29 AD patients （87. 88% ） and in 22 control patients （59.46%） （P 〈 0. 05）. Snoring everyday occurred in 19 AD patients （57.58%） and in 12 controls （32. 43% ） （P 〈 0. 05）. Loud snoring was reported from 23 AD patients （69. 70% ） and 10 controls （27.03%） （P 〈0. 05）. Apnea occurred in 15 AD patients （45.45%） and 8 controls （21.62%） （ P 〈 0. 05）. Apnea nearly everyday occurred in 9 AD patients （27.27%） and 5 controls （ 13.51% ） （ P 〈 0. 05）. Fatigue after sleep occurred in 23 AD patients （69.70%） and 15 controls （40. 54% ） （P 〈0. 05）. Fatigue nearly everyday after sleep occurred in l0 AD patients （30. 30% ） and 6 controls （ 16. 22% ） （P 〈 0. 05）. Hypertension was found in 28 AD patients （84. 85% ） and 20 controls （54. 05% ） （ P 〈 0. 05 ）. The average age of hypertensive control were 62± 16, greater than that of AD group （ P 〈 0. 05 ）. In the 20 hypertensive control patients, loud snoring in 7 （ 35% ） , lessen than that of AD group （ P 〈 0. 05 ）.Compared with hypertensive controls, AD patients had greater body length （ P 〈 0. 05 ） and lesser waist-to-hip ration （P 〈 0. 05 ）. Conclusions Compared with normal control, OSAS is more common in AD patients.