老年人睡眠呼吸暂停综合征诊治特点的初步探讨

A preliminary study of the diagnostic and therapeutic characteristics of sleep apnea syndrome in the aged

目的 探讨老年人睡眠呼吸暂停综合征（ＳＡＳ）的临床及治疗特点。 方法 用ＡｌｉｃｅⅢ型多导睡眠监测仪对可疑ＳＡＳ老年人９２ 例及非老年人１２９ 例进行７ 小时睡眠监测。 结果 老年人ＳＡＳ与非ＳＡＳ临床表现无差异，老年人ＳＡＳ比非老年人ＳＡＳ诊断率低，分别为５８７％ 和７９８％（Ｐ＜ ００１）；体质指数、鼾声及最低血氧饱和度均较非老年人程度轻，且混合型ＳＡＳ增多，随增龄重度ＳＡＳ减少，并存疾病增多。１０ 例老年人ＳＡＳ经鼻持续气道正压（ＮＣＰＡＰ）治疗前后各项指标显著改善（Ｐ＜ ００１）。 结论 老年人ＳＡＳ病情复杂，鉴别诊断困难，易漏误诊；采用ＮＣＰＡＰ治疗疗效显著。

Objective To study the diagnostic and therapeutic characteristics of sleep apnea syndrome in the aged. Methods Ninety two aged and 129 non aged subjects of sleep apnea syndrome(SAS) underwent 7 hour polysomnography with Alice Ⅲ polysomnography device and their data were analyzed. Results There was no difference in the clinical presentation between SAS and NSAS in the aged. The correct diagnostic rate of SAS in the aged group (58 7%) was less than that in the non aged group(79 8%) ( P <0 01) and so were the body index, snore and minimum of arterial O 2 saturation. With increase of age, the severity of SAS decreased, but the number of mixed type SAS increased and so did the complications. There was a significant improvement of the data after treatment with nasal continuous positive pressure (NCPAP) in 10 cases. Conclusions The characteristics of SAS in the aged as compared with those of the non aged are more complicated, the diagnosis is more difficult and misdiagnosis is more likely to be made. Initial diagnosis is also hard to make. NCPAP is usually recommended for treatment and the outcome is satisfactory.