中重度睡眠呼吸暂停综合征合并肺动脉高压的临床特征分析

Analysis of clinical characteristics of moderate-to-severe obstructive sleep apnea syndrome with pulmonary hypertension

目的探讨中重度阻塞性睡眠呼吸暂停低通气综合征患者肺动脉高压(PAH)的发生率及其相关危险因素,预测其对PAH发生、发展的影响。方法纳入2013年4月—2013年12月在河南省人民医院睡眠呼吸障碍诊疗中心住院的105例患者,所有患者均经多守睡眠检测仪(PSG)确诊为中重度阻塞性睡眠呼吸暂停低通气综合征。采用SPSS14.0软件进行统计分析。结果 1105例中重度睡眠呼吸低通气综合征患者中,22例合并PAH,PAH发病率为20.9%。2PAH组(PAH)患者TST-Sp O2<80%、TST-A、AHI、最大氧减明显高于对照组,平均血氧饱和度(Sp O2)、最低Sp O2明显低于对照组(P<0.05);两组患者TST-Sp O2<90%和TST-HY相比无明显差别(P>0.05)。3多因素二分类Logistic回归分析提示,TST-A、AHI和平均Sp O2可作为OSAHS并发PAH的危险因素(P<0.05)。结论中重度阻塞性睡眠呼吸暂停低通气综合征中PAH的发生率为20.9%。TST-A、AHI和平均Sp O2是中重度OSAHS并发PAH的独立危险因素。

Objective To investigate the incidence of pulmonary hypertension in moderate - to - severe obstructive sleep apnea patients and analyse the correlated factors. Methods 105 cases of patients hospitalized in Sleep - disordered Breathing Clinic Center of Henan Provincial People＇s Hospital from April 2013 to December 2013. All the patients were diagnosed as moderate - to - severe obstructive sleep apnea syndrome by PSG. Difference was considered as statistically significant when P 〈 0. 05. Results （1）22 out of 105 cases of patients with moderate - to - severe sleep apnea hypopnea syndrome suffering from pulmonary hypertension, and the incidence was 20. 9%. （2）TST - SpO2 〈 80%, TST - A, AHI and maximum oxygen reductionin in pulmonary hypertension group （PAH） were significantly more than that in control group（P 〈0. 05 ）,while mean SpO2 and minimum SpO2 were significantly less than that in control group（ P 〈 0. 05 ）. TST- SpO2 〈 90% and TST- HY in two groups had no significant difference （P 〉 0. 05 ）. （3）Multi -factor Binary Logistic regression analysis revealed that TST - A, AHI and mean SpO2 were independent risk factors （ P 〈 0. 05 ）. Conclusion The probability of moderate - to - severe obstructive sleep apnea syndrome complicated by pulmonary hypertension is 20.9%. TST - A, AHI and the mean SpO2 are independent risk factors for pulmonary hypertension resulting from moderate -to -severe obstructive sleep apnea syndrome.