摘要
目的观察阻塞性睡眠呼吸暂停综合征(OSAS)与非阻塞性睡眠呼吸暂停综合征(非OSAS)患者24h眼压的变化。方法OSAS患者60例分为两组:OSAS组30例与非OSAS组30例;分别进行(1)清醒时血氧饱和度[(HSaO2)%];(2)最低血氧饱和度[(LSaO2)%];(3)平均血氧饱和度[(MSaO2)%];(4)氧减饱和度指数[(ODI4),每小时血氧饱和度下降≥4%的次数];(5)血氧饱和度≤90%的时间占总监测时间的百分比[(SIT90)%]。以及24h眼压监测,眼压测量时间为晨起5:00开始,每间隔4小时测量1次,两组测量结果进行统计学分析。结果OSAS组与非OSAS组患者年龄[(62.60±12.44)、(65.20±10.66)岁,t=1.48]、病程[(22.40±6.88)、(25.49±7.22)个月,t=1.97]、性别[男、女例数分别为20、10例,17、13例,X^2=0.007]比较,差异无统计学意义(P均〉0.05)。两组睡眠呼吸紊乱指数[(27.9±6.0)、(2.5±1.1),t=8.78]、LSaO2[(74.7±11.7)%、(91.8±5.9)%,t=3.44]、SIT90[(13.2±12.4)%、(0.2±1.1)%,t=9.92]及ODI4[(28.9±13.9)、(6.1±4.1)次/h,t=8.09]比较,差异均有统计学意义(P〈0.05或P〈0.01),OSAS组高于非OSAS组。两组患者24h6个不同时间点眼压变化情况比较,夜间21:00眼压[(20.61±4.15)、(19.60±4.03)mmHg,t=2.18]、1:00眼压[(23.12±3.11)、(20.60±3.29)mmHg,t=4.64]及凌晨5:00眼压[(22.82±2.99)、(17.21±3.55)mmHg,t=4.23]比较,两组间差异有统计学意义(P〈0.05或P〈0.01),OSAS组高于非OSAS组。两组患者24h眼压差[(10.40±2.85)、(8.40±2.55)mmHg,t=4.15]比较,差异有统计学意义(P〈0.01),OSAS组高于非OSAS组;两组眼压峰值均出现在夜间,眼压峰值[(23.60±3.29)、(21.23±3.43)mmHg,t=2.60]比较,差异有统计学意义(P〈0.05),OSAS组高于非OSAS组;两组眼压谷值[(13.20±4.08)、(12.70±4.22)mmHg,t=0.54]比较差异无统计学意义(P〉0.05)。结论OSAS患者较非OSAS患者夜间眼压更高,且高于白天,24h眼压波动明显、眼压峰值更高,OSAS患者更应关注眼压以保护患者的视功能。
Objective To compare the changes of intraocular pressure (IOP) in 24 hours between obstructive sleep apnea syndrome(OSAS) and the non-obstructive sleep apnea syndrome(non-OSAS). Methods Sixty patients with OSAS were divided into two groups:OSAS group( n = 30) and non-OSAS group( n = 30). The following indicators were detected : ( 1 ) Awake oxygen saturation ( ( HSaO2 ) % ) , ( 2 ) The lowest oxygen saturation ( LSaO2 ) % ) ; ( 3 ) Mean oxygen saturation ( ( MSaO2 % ) ) ; ( 4 ) Oxygen desaturation index ( ( DI4 ), time/h : number of times that the hourly oxygen desaturation ≥ 4% ) ; ( 5 ) The percentage of the time that oxygen saturation ≤90% accounts the total time (( SIT90 )% ) and 24-hour lOP. lOP was measured from early morning 5:00 and measured once every four hours. The measurement results were compared between two groups. Results There was no significant difference on age ( (62. 60 ± 12.44) years old vs (65.20 ± 10. 66) years old, t = 1.48), Course of disease ( ( 22. 40 ± 6. 88 ) month vs ( 25.49 ± 7.22 ) month, t = 1.97 ), gender (The ratio of male to female is(20/10)vs (17/13), X^2 = 0. 007 ) between the OSAS and the non-OSAS( P 〉 0.05). ValueofAHI(h-1) ((27.9 ±6.0) vs (2.5±1. 1),t=8.78),LSaO2((74.7±11.7)% vs (91.8± 5.9)%,t=3.44 ),SIT90((13.2±12.4)% vs(0.2±1. 1)%,t=9.92) andODI4(h-1) ((28.9±13.9)vs (6. 1 ±4. 1 ) ,t =8. 09 ) of OSAS was significantly higher than that of non-OSAS(P 〈0. 05 or P 〈0. 01 ). Valueof lOP of 21:00 o'clock( ( 20. 61 ± 4. 15 ) mm Hg vs ( 19.60 ± 4. 03 )mm Hg, t = 2. 18 ), 1 : 00 o'clock( (23.12 ± 3.11 ) mm l-Ig vs ( 20. 60 ± 3.29 ) mm Hg, t = 4. 64 ) and 5 : 00 o' clock ( ( 22. 82 ± 2. 99 ) mm Hg vs ( 17.21 ± 3.55)mm Hg,t =4. 23) of OSAS was significantly higher than that of non-OSAS(P 〈0. 05 or P 〈0. 01 ). The wave( ( 10. 40 ± 2. 85 )mm Hg vs ( 8.40±2. 55 ) mm Hg, t = 4. 15 ) and maximal ( ( 23.60 ± 3.29 ) mm Hg vs (21.23 ±3.43)mm Hg,t =2. 60) value of lOP of OSAS was significantly higher than that of non-OSAS(P 〈 0. 05 or P 〈 0. 01 ). There was no significant difference on minimum of lOP between the OSAS and the non-OSAS ( ( 13.20 ± 4. 08 ) mm Hg vs ( 12. 70 ± 4. 22 )mm Hg, t = 0. 54, P 〉 0. 05 ). Conclusion There are higher wave and maximal value of lOP in the patients of OSAS during the night. It is important to pay attention to lOP in order to protect those patients' visual function.
出处
《中国综合临床》
2013年第1期48-53,共6页
Clinical Medicine of China