老年人阻塞性睡眠呼吸暂停低通气综合征与多器官疾病关系的长期随访

A long-term follow-up of the correlation between obstructive sleep apnea hypopnea syndrome and multiple organ diseases

目的 随访观察老年人中OSAHS与多器官疾病的关系.方法 前瞻性纳入1989年11月至2009年11月13所军队和地方离退休干部休养所定期体检的老年人共1 868例,其中男956例,女912例,平均年龄（79±5）岁.多器官疾病主要包括：高血压、冠心病、脑卒中、糖尿病、肺源性心脏病、肾功能不全和红细胞增多症.采用家访式调查,随访期间每年进行1次体检,随访时间20年.根据随访对象是否确诊OSAHS分为OSAHS组和对照组.结果 1 868例中纳入OSAHS组598例（32.0％）,对照组1 270例（68.0％）.达到随访终点时OSAHS组多器官疾病患病率为：高血压477例（79.8％）,冠心病337例（56.4％）,脑卒中167例（27.9％）,糖尿病76例（12.7％）,肺源性心脏病37例（6.2％）,肾功能不全73例（12.2％）,红细胞增多症211例（35.3％）,均高于对照组[323例（25.4％）,315例（24.8％）,95例（7.5％）,69例（5.4％）,40例（3.2％）,58例（4.6％）,30例（2.4％）,P＜0.01]；OSAHS组患病种类也高于对照组（P＜0.05）.结论 OSAHS患者发生多器官疾病较一般人群高,提示OSAHS可能是多器官疾病的危险因素,其机制可能与OSAHS引起缺氧性损害、内分泌和代谢紊乱、生活方式不良和动脉硬化等有关.

Objective To explore the correlation between obstructive sleep apnea hypopnea syndrome（OSAHS） and multiple organ diseases.Methods Home-visit questionnaires were performed in 1 868 subjects （956 male,912 female） with an average age of （79 ±5） years,and a prospective follow-up was performed for a period of 20 years with annual medical examinations.Multiple organ diseases included hypertension,coronary heart disease,stroke,diabetes,pulmonary heart disease,renal insufficiency and erythrocytosis.The subjects were grouped by the diagnosis of OSAHS.Results Among the 1 868 subjects,598 （32.0%） were diagnosed with OSAHS,and 1 270 （68.0%） of non-OSAHS as the control group.By the end of follow-up,in the OSAHS group there were 477（79.8%） cases with hypertension,337（56.4%） cases with coronary heart disease,167 （27.9%） cases with stroke,76 （12.7%） cases with diabetes,37 （6.2%） cases with pulmonary heart disease,73 （12.2%） cases with renal insufficiency and 211 （35.3%） cases with erythrocytosis,all of which were significantly higher than those of the control group [323 （25.4%）,315（24.8%）,95（7.5%）,69（5.4%）,40（3.2%）,58（4.6%）,30（2.4%）,P〈0.01].The number of diseases in the OSAHS group was also higher than that in the control group （P 〈 0.05）.Conclusion The incidence of multiple organ diseases was remarkably higher in the OSAHS group than that in the control group,which indicated that OSAHS was a risk factor for multiple organ diseases.These diseases in OSAHS patients may be related to hypoxia caused by OSAHS,endocrine and metabolic disorders,unhealthy lifestyles and arteriosclerosis