阻塞性睡眠呼吸暂停低通气综合征患者日步行量的研究

The Change of Steps Walked Daily in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者日步行量的变化及经鼻持续气道正压通气(nCPAP)对其的影响。方法选择经多导睡眠图确诊的OSAHS患者62例,进一步分为轻、中、重度组,并设健康对照组28例。10例中重度OSAHS患者接受经鼻持续气道正压通气(nCPAP)治疗1个月。比较各组间Epworth嗜睡量表(ESS)评分、FOSQ生活质量问卷调查表(FOSQ)评分,并通过电子计步器测量日步行量。结果与对照组和轻度组比较,中重度组OSAHS患者ESS评分显著增高(11.4±2.7和12.2±2.5比6.5±2.3和7.0±2.1,P<0.05),FOSQ评分显著降低(48.1±9.4和40.5±9.8比90.3±7.1和85.1±12.6,P<0.05),日步行量显著降低[3 802(2 203～6 545)步和3 254(1 657～5 218)步比8 259(5 348～14 603)步和8 693(5 743～12 042)步,P<0.05]。轻度组与对照组ESS评分、FOSQ评分及日步行量差异无统计学意义(P>0.05)。OSHAS患者日步行量与FOSQ评分呈正相关(r=0.783,P<0.05),与ESS评分、呼吸暂停低通气指数(AHI)、氧减指数(ODI)、血氧饱和度低于90%的时间占睡眠总时间的百分比(SIT90)及体重指数(BMI)呈负相关(r值分别为-0.575、-0.735、-0.748、-0.602和-0.467,P<0.05)。10例中重度OSAHS患者经nCPAP治疗后,日步行量及FOSQ评分较治疗前显著增高,而ESS评分较治疗前显著降低(P<0.05)。结论 OSAHS患者日步行量较对照组明显降低,并与疾病严重度密切相关,直接反映OSAHS患者日常活动量减少,可能影响其生活质量和身心健康。nCPAP治疗可显著改善患者的日步行量。

Objective To investigate the changes of steps walks daily in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） before and after the initiation of nasal continuous positive airway pressure （nCPAP） ventilation. Methods 62 patients diagnosed by polysomnogaphy （PSG） in the sleep respiratory disease center of Nanjing First Hospital Affiliated to Nanjing Medical University were recruited as the OSAHS group, and divided into mild, moderate, and severe subgroups according to apnea-hypopnea index （AHI）. 28 subjects without OSAHS were recruited as the control group. All the subjects were evaluated by Epworth Sleepiness Scale （ESS） and Functional Outcomes of Sleep Questionnaire （ FOSQ ）. Steps walked daily were measured by electronic pedometer. 10 patients with moderate and severe OSAHS were treated with nCPAP. Results Compared with the control group and the mild OSAHS patients, ESS scores were significantly higher while FOSQ scores and steps walked daily were significantly lower in the moderate and severe OSAHS patients （ P 〈 0.05 ）. In the OSAHS patients, steps walked daily were correlated positively with FOSQ scores but negatively with BMI, ESS scores, AHI, oxygen desaturation index （ODI） and saturation impair time below 90% （ SIT90 ） （ P 〈 O. 05 ）. After one month of nCPAP therapy, ESS scores were significantly decreased, FOSQ scores and steps walked daily were significantly increased （P 〈0. 05）.Conclusions Increased OSAHS severity is associated with decreased steps walked daily which is an objective index of routine physical activity. Untreated OSAHS may negatively impact the patients＇ ability to have an active lifestyle, nCPAP therapy can significantly improve steps walks daily of patients with OSAHS.