ESS评分在评估OSAHS患者血清甲状腺激素、皮质醇水平中的应用

The application of ESS score in the evaluation of serum thyroid hormone and cortisol in patients with OSAHS

目的通过分析OSAHS患者甲状腺功能、皮质醇水平与Epowrth嗜睡评估表（ESS评分）的关系，探讨ESS评分在评估OSAHS患者甲状腺功能、皮质醇水平中的价值。方法选择86例OSAHS患者为实验组，18例单纯性鼾症患者为对照组。记录一般资料以及PSG检测参数，运用放射免疫分析法检测患者血清游离三碘甲状腺原氨酸（FT3）、血清游离甲状腺素（FT4）、促甲状腺激素（TSH）及皮质醇浓度。结果①FT4、TSH在单纯性鼾症组、轻度OSAHS组间差异无统计学意义（P〉0．05），中度OSAHs组、重度OSAHS组逐渐降低，组间差异有统计学意义（FT4，P〈0．01，TSH，P〈0．05）；FT3各组间差异无统计学意义（P〉0．05）。②皮质醇水平在单纯性鼾症组、轻度OSAHS组间差异无统计学意义（P〉0．05），中度OSAHS组、重度OSAHS组逐渐升高，组间差异有统计学意义（P〈0．01）。③ESS评分与FT4（r=-0．754，P=0．00）、TSH（r=-0．598，P=0．00）呈负相关，与FT3无明显相关（P〉0．05），多重线性回归分析显示ESS评分为FT4的主要预测因素。④ESS评分与皮质醇呈正相关（r=0．81，P=0．00）。Logistic分析发现ESS评分与皮质醇水平密切相关。结论ESS评分能较好预测0sAHs患者病情、甲状腺功能、皮质醇水平，是简便可靠的初筛方法。

Objective By analyzing the relationship between thyroid function and cortisol level and ESS score in patients with OSAHS,the value of ESS score in evaluating thyroid function and cortisol level in patients with OSAHS was discussed. Methods Eighty-six cases of OSAHS were selected as the experimental group,and eighteen cases with simple snoring patients were selected as the control group. Then,general information and PSG testing parameters of patients were recorded and analysed. Serum FT3,FT4,TSH and serum cortisol concentration were detected by radioimmunoassay. Results ① The levels of FT4 and TSH were no significant difference （ P 〉0.05） between the simple snoring group and the mild OSAHS group, while they were gradually decreased between the moderate OSAHS group and the severe OSAHS group, which had a statistically significant difference between groups （FT4, P 〈0.01, TSH, P 〈0.05）, FT3 was no significant difference （ P 〉 0.05） between the groups. ②The level of control was no significant difference （ P 〉0.05） between simple snoring group and the mild OSAHS group,while it was gradually increased between the moderate OSAHS group and the severe OSAHS group,which had a statistically significant difference between groups （FT4, P 〈0.01 ,TSH, P 〈0.05）. ③ESS score was negatively correlated with FT4 （ r = -0. 754, P = 0.00）,TSH （ r = -0. 598, P = 0.00）, while it was not significantly correlated with FT3 （ P 〉 0.05）. Multiple linear regression analysis showed that ESS score was the main predictor of FT4. ④ESS score was positively correlated with serumcontrol （r =0.81, P =0.00）. Logistic regression analysis found that ESS score was closely correlated with cortisol. Conclusions ESS score is better able to reflect the illness,thyroid function,cortisol level in patients with OSAHS,which may become a simple and reliable screening method on evaluating thyroid function and cortisol level of OSAHS.