老年与中青年阻塞性睡眠呼吸暂停低通气综合征患者临床表现和多导睡眠特征的差异

Differences in Clinical and Polysomnographic Variables between Elderly Patients and Young and Middle-aged Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

目的探讨中国老年阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与中青年OSAHS临床特点和多导睡眠特征的差异。方法分析37例老年OSAHS和294例中青年OSAHS的临床表现和多导睡眠图特点,并按体重指数(BMI)匹配比较两组多导睡眠指标差异。结果老年OSAHS的症状除夜尿频率更高外(P=0.01),其他与中青年组差异无统计学意义。老年组体重指数更低(P=0.018),颈围更小(P=0.003),合并糖尿病(P=0.001)和高血压病(P<0.001)更多。老年组Ⅰ、Ⅱ期睡眠时间(P<0.001)和占总睡眠时间比例更高(P<0.001)。两组之间睡眠呼吸暂停低通气指数差异无统计学意义(P=0.082)。老年组的夜间最低血氧饱和度较中青年组高(P=0.009),但调整体重影响后这种差异消失(P=0.114)。结论老年组OSAHS主要临床表现与中青年组相似,老年OSAHS患者比中青年组体重更轻,并发症更多,夜尿更频繁。中青年组比老年组夜间最低血氧饱和度更低可能与BMI更高有关。

Objective To investigate the differences in clinical characteristics and polysomnographic characteristics between the elderly obstructive sleep apnea-hypopnea syndrome （OSAHS） patients and the young and middle-aged OSAHS patients. Methods The clinical manifestations and the polysomnographic characteristics of 37 elderly OSAHS patients and 294 young and middle-aged patients were analyzed. The differences in polysomnographic indicators between two groups were compared according to the body mass index. Results The nocturia frequency in the elderly OSAHS patients was higher （ P = 0.01 ） , however,the othert clinical manifestations between the elderly group and the young and middle-aged group were not different significantly. The elderly group had a lower body mass index （P =0. 018） ,a smaller neek circumference （ P = 0. 003 ） , and a larger chance of diabetes （ P = 0. 001 ） and hypertension （ P 〈 0. 001 ）. The phase I and phase H sleep of the elderly group took a longer duration （ P 〈 0. 001 ） and a larger proportion（ P 〈 0. 001 ）. The sleep apnea-hypopnea index between two groups did not show any significant difference（ P = 0. 082）. The lowest night oxyhemoglobin saturation of the elderly group was higher than that of the young and middle-aged group （P = 0. 009 ） , but such difference disappeared after adjustment by weight （ P = 0. 114 ）. Conclusions The major clinical manifestations of the elderly OSAHS patients are similar to the young and middle-aged patients. The elderly patients are thinner than the young and middle-aged patients, but have more complications and a higher frequency of nocturia. The night oxyhemoglobin saturation is lower in young and middle-aged patients which is associated with higher body mass index.