移居汉族高原红细胞增多症多导睡眠监测

Polysomnography of high altitude polycythemia in migrant Han

目的研究高原红细胞增多症(High altitude poly cythemia,HAPC)夜间睡眠呼吸及血氧饱和度(arterial oxy-gen saturation,SaO2)特点,为临床合理治疗提供依据。方法以40例患HAPC的汉族移居者为研究对象(HAPC组),并以20例健康的汉族移居者作为对照组。2组在安静、舒适的睡眠监测室内行整夜多导睡眠监测。观察呼吸暂停/低通气指数(apnea-hypopnea index,AHI)、呼吸暂停指数(apnea index,AI)、低通气指数(hypopnea index,HI)、清醒SaO2(awakeSaO2,ASaO2)、睡眠平均SaO2(mean SaO2,MSaO2)、最低SaO2(lowest SaO2,LSaO2)、SaO2下降百分比(percentage of reducedSaO2,A-MSaO2%)、氧减饱和度指数(oxygen desaturation index,ODI4)、氧减时间百分比(percentage of time for ODI4,TODI4%)等指标。睡眠监测后填写匹兹堡睡眠质量问卷(pittsburgh sleep quality index,PSQI),并抽取静脉血检测红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,HGB)、红细胞压积(haematocrit,HCT)。结果 HAPC组RBC、HGB、HCT显著高于对照组(P<0.01);2组PSQI总分及各因子计分无显著差异性(P>0.05);2组AHI、AI无显著差异(P>0.05),但HAPC组HI显著高于对照组(P<0.05);HAPC组ASaO2、MSaO2、LSaO2显著低于对照组,A-MSaO2%、ODI4、TODI4%显著高于对照组(P<0.05)。结论 HAPC患者夜间睡眠期间以低通气及SaO2水平显著降低为主要特征。

Objective To investigate the characteristics of sleep-related breathing and blood oxygen saturation （SaO2 ） of high altitude polycythemia （HAPC） in migrant Han in order to provide evidence for therapy. Methods Polysomnography （PSG） were performed on 40 HAPC and 20 healthy volunteers （control group） of migrant Han ethnic in a quiet and comfortable room. The apnea-hypopnea index （ AHI）, apnea index （ AI）, hypopnea index （ HI）, awake SaO2 （ ASaO2 ） , mean SaO2 （ MSaO2 ） , lowest SaO2 （ L SaO2 ） , percentage of reduced SaO2 （ A-MSaO2 % ）, oxygen desaturation index （ ODI4 ） and percentage of time for ODI4 （ TODI4 % ） were calculated. Pittsburgh Sleep Quality Index （PSQI） was employed to evaluate the sleep quality measured after PSG. Red blood cells （ RBC）, hemoglobin （ HGB）, and haematocrit （HCT） were compared between 2 groups. Results RBC, HGB, and HCT were significantly higher in HAPC group （ P 〈 0.01 ） , while there was no significant difference in total score and every score of PSQI between 2 groups （ P 〉 0.05 ）. Although there was no difference in AHI and AI （P 〉 0.05 ） , HI was significantly higher in HAPC than in control group （P 〈 0.05）. ASaO2, MSaO2 and LSaO2 were obviously lower, but A-MSaO2%, OD]4 and TODI4% were remarkably higher in HAPC than in control group （P 〈 0.05 ）. Conclusion HAPC in migrant Han high altitude dwellers are characterized as hypoventilation and hyoxemia during sleeping.