阻塞性睡眠呼吸暂停低通气综合征和单纯鼾症患者鼾声声压级参数分析

Analysis of sound pressure level parameters of snoring sounds in patients with obstructive sleep apnea-hypopnea syndrome and simple snoring

目的研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)和单纯鼾症(SS)患者鼾声的声压级特点,探讨其临床应用价值。方法对45例OSHAS患者和20例SS患者进行同步多导睡眠监测和鼾声声压级监测(sound pressure level,SPL),提取其整夜7 h鼾声的等效连续A声级(LAeq),峰值(Lpeak),累积百分数声级(L10、L50和L90)等声压级参数,与睡眠呼吸暂停低通气指数(AHI)、体质量指数(BMI)及年龄进行相关性分析。结果 SS和OSAHS患者鼾声的LAeq和L10差异有统计学意义。OSAHS患者的AHI值与LAeq、Lpeak、L10呈正相关,相关系数分别为0.676、0.457、0.653。BMI与LAeq和L10呈正相关,相关系数分别为0.341和0.379,年龄与LAeq呈负相关,相关系数为-0.279。结论①鼾声的声级参数的大小受患者的AHI大小、BMI及年龄因素影响,而AHI的影响最大,其中又以整夜鼾声的LAeq和L10与AHI关系最为密切;②LAeq和L10能在一定程度上反映睡眠呼吸障碍的严重程度,是鼾声的重要声学特征,对于粗略鉴别SS和OSAHS及评估OSAHS的严重程度具有一定的临床价值。

Objective To investigate the characteristics and clinical values of sound pressure level （ SPL） of snoring sounds in patients with obstructive sleep apnea-hypopnea syndrome （ OSAHS） and simple snoring （ SS） .Methods 45 patients with OSAHS and 20 patients with SS underwent polysomnography and simultaneously snoring SPL recording. Equivalent continuous sound level A （LAeq）, peak level （Lpeak） and cumulative percent level （L10, L50 and L90） of the 7 hour-snoring were subtracted, and the correlations with AHI, BMI and age were analyzed.Results The differences of LAeq and L10 between snoring sounds of SS and OSAHS were statistically significant.Positive correlation was found between AHI and LAeq , Lpeak , L10 with the coefficients of 0.676, 0.457 and 0.653 respectively.BMI was positively correlated to LAeq and L10 with the coefficients of 0.341 and 0.379 respectively.Age was negatively correlated to LAeq and the coefficient was -0.279.Conclusion 1.The SPL parameters of overnight snoring sounds are affected by AHI, BMI and age of patients, among which the effect of AHI is the greatest.LAeq and L10 of the snoring sounds have the strongest correlation to AHI.2.LAeq and L10 are important acoustic characteristics of snoring sounds.It appears that they may have clinic value on roughly distinguish OSAHS from SS and evaluate the severity of OSAHS.