中、重度OSAHS患者上气道不同阻塞部位鼾声声压级指标分析

An Analysis of Snoring Sound Pressure Level Parameters in Obstructive Sleep Apnea Hyperpnoea Syndrome Patients with Different Obstructive Site

目的研究中、重度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hyperpnoea syndrome,OSAHS)患者上气道不同阻塞部位与鼾声声压级指标的关系。方法对46例经多导睡眠监测诊断为中度或重度OSAHS的患者进行整夜同步上气道测压和鼾声声压级记录,分析上气道阻塞部位构成比、每小时上部(软腭游离缘平面以上)和下部(软腭游离缘平面以下)阻塞次数与鼾声声压级分析指标中等效连续A声级(equivalent continuous A-weightedsound level,L_(Aeq))和最大声压级(L_(10))的相关性,以及上气道阻塞部位的类型、呼吸暂停低通气指数(AHI)及体质量指数(BMI)对鼾声声压级指标的影响。结果 OSAHS患者上气道上/下部阻塞构成比和每小时上部及下部阻塞次数均与L_(Aeq)和L_(10)无明显相关性,L_(Aeq)和L_(10)的影响因素为AHI,而阻塞部位及BMI对L_(Aeq)和L_(10)无影响。结论 L_(Aeq)和L_(10)的大小与AHI有关而与阻塞部位无明确关系,L_(Aeq)和L_(10)可能有助于初步判断OSAHS患者的严重程度,对阻塞部位的辨别缺乏临床价值。

Objective To investigate the relationship between sound pressure level parameters of snoring sound and obstructive sites in patients with media or severe obstructive sleep apnea hypopnea syndrome（OSAHS）.Methods Forty-six patients with media or severe OSAHS were included in this study.All underwent continuous upper airway pressure measurements and snoring sound pressure level recording simultaneously.The correlations between obstructive site,AHI,BMI and sound pressure level parameterssuch as equivalent continuous sound level（L_（Aeq））and maximum sound pressure level（L_（10））were analyzed.Results Both L_（Aeq）and L_（10） were affected only by AHI,whereas unrelated to obstructive site and BMI.Conclusion There is no definite relationship between the site of obstruction and sound pressure level parameters of snoring sound.It appears that L_（Aeq）and L_（10） may be helpful to evaluate the severity of OSAHS,but may have no clinical value on distinguishing obstructive sites.