阻塞性睡眠呼吸暂停低通气综合征患者鼾声的声学特征研究

Acoustic characteristics of snoring sound in patients with obstructive sleep apnea hypopnea syndrome

目的:描述阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者鼾声的声学特征,为鼾声分析应用于OSAHS的诊断、治疗及结果评价奠定基础。方法:记录31例OSAHS患者整夜睡眠的鼾声和PSG监测。应用Adobe Audition软件提取鼾声,将鼾声信号转为数字信号,分别随机提取每个患者呼吸暂停后的第1个鼾声和不伴有呼吸暂停的鼾声各10个,共计620组鼾声数据。运用Matlab软件程序分析、比较两类鼾声的各项声学指标:鼾声的最大频率、中心频率、平均频率、峰频率、功率比等。结果:OSAHS患者的呼吸暂停后鼾声的最大频率、峰频率、平均频率、中心频率均大于连续鼾声,而800 Hz功率比则相反,这些指标的差异均有统计学意义(P<0.01或0.05)。将患者根据AHI值分为轻、中、重度三组,轻度组两类鼾声的峰频率、中心频率和800Hz功率比差异有统计学意义(P<0.01);而中、重度患者的指标中除了中心频率外,其余指标差异均有统计学意义(P<0.01或0.05)。结论:800Hz功率比可能是区别OSAHS患者呼吸暂停后鼾声与平稳呼吸时产生的连续鼾声不同的声学指标,提示将鼾声监测分析技术应用于OSAHS的诊断与筛查具有一定可行性,为进一步分析研究鼾声在临床中的应用提供了一个很好的线索。

Objective：To investigate the acoustic characteristics of snoring sound：in patients with obstructive sleep apnea hypopnea syndrome（OSAHS）. Method：Thirty-one patients with OSAHS were included in this study. Natural overnight snoring was digitally recorded and polysomnography（PSG） was performed simultaneously. Thirty hundred and ten snores which after obstructive apnea and 310 continuous snores which not after obstructive apnea were extracted and peak frequency, maximal frequency,mean frequency, central frequency and power ratio were analyzed. Result：The maximal frequency, peak frequency, mean frequency and central frequency of the snores which after obstructive apnea was higher than that of the continuous snores. But 800 Hz power ratio of the snores which after obstructive apnea was lower than those of the continuous snores. The differences of all parameters were of statistical significance（P〈0.01 or 0.05）. The patients were divided into mild, moderate and severe groups according to AHI, it were seen that in mild patients group peak frequency, central frequency and 800 Hz power ratio were of statistical difference（P^0.01） ; and in moderate and severe patients groups,in addition to fc, the rest of the index difference was statistically significance except central frequency（ P〈0.01 or 0.05）. Conclusion： 800 Hz power ratio is a good index for distinguishing the two kind of snores of OSAHS patients. It indicates that it is feasible to study the OSAHS by way of snore monitoring and analyzing technique employed in this study.