女性阻塞性睡眠呼吸暂停低通气综合征与性激素相关关系研究

Association of obstructive sleep apnea-hypopnea syndrome with the serum hormone in females

目的分析女性OSAHS的危险因素,以及性激素与OSAHS的相关关系。方法选择2013年1月~2015年12月遵义医学院附属医院诊治的OSAHS女性患者173例,同期收集346例健康女性作为对照。收集两组的一般人口学特征、性激素六项水平、多导睡眠图(PSG)监测等指标进行统计分析。结果 Logistic回归分析结果显示:绝经(OR=1.89,95%CI=1.28~2.80)、患有高血压(OR=3.39,95%CI=2.11~5.45)、颈围(OR=1.72,95%CI=1.54~1.92)、BMI(OR=1.25,95%CI=1.06~1.48)和促泌乳素(PRL)(OR=1.39,95%CI=1.19~1.61)是患OSAHS的危险因素(P<0.05);而促卵泡刺激素(FSH)(OR=0.90,95%CI=0.88~0.91)、黄体生成素(LH)(OR=0.79,95%CI=0.75~0.82)、雌二醇(E_2)(OR=0.92,95%CI=0.87~0.97)、总睾酮(TT)(OR=0.13,95%CI=0.05~0.33)和孕酮(P)(OR=0.95,95%CI=0.89~0.99)是患OSAHS的保护因素(P<0.05)。Pearson相关分析结果显示:FSH、LH、E_2、TT与呼吸暂停低通气指数(AHI)、血氧饱和度<90%的累积时间占总睡眠时间的百分比(TS90%)呈负相关(r<0,P<0.01),PRL、P与其呈正相关(r>0,P<0.01)。FSH、LH、E_2、TT与最低血氧饱和度(LSaO_2)呈正相关(r>0,P<0.01),而PRL、P与其呈负相关(r<0,P<0.01)。结论性激素FSH、LH、PRL、E_2、P和TT与OSAHS的患病风险有相关性,并且绝经、高血压、颈围、BMI是OSAHS的危险因素。

Objective To analyze the risk factors of obstructive sleep apnea-hypopnea syndrome （OSAHS） in females, and the relationship between sex hormones and OSAHS. Methods From January 2013 to December 2015, in Affiliated Hospital of Zunyi Medical College, 173 females OSAHS were selected, and 346 health femal were selected as control at the same time. The demographic, sex hormones, and PSG related variables were selected and analyzed. Results The Logistic analysis results showed that menopause （OR = 1.89, 95%CI = 1.28-2.80）, hypertension （OR = 3.39, 95%CI = 2.11-5.45）, high neck circumfrence （OR = 1.72, 95%CI = 1.54-1.92）, high BMI （OR = 1.25, 95%CI = 1.06-1.48） and PRL （OR = 1.39, 95%CI = 1.19-1.61） were risk factors of OSAHS （P 〈 0.05）; the FSH （OR = 0.90, 95%CI = 0.88-0.91）, LH （OR = 0.79, 95%CI = 0.75-0.82）, E2 （OR = 0.92, 95%CI = 0.87-0.97）, TT （OR = 0.13, 95%CI = 0.05-0.33） and P（OR = 0.95, 95%CI = 0.89-0.99） were protective factor of OSAHS （P 〈 0.05）. Pearson correlation analysis showed that the FSH, LH, E2 and TT values showed negative association with AHI and TS90% （ r〈 0, P 〈 0.01）, but the PRL and P values displayed positive association （r 〉 0, P 〈 0.01）. FSH, LH, E2 and TT values expressed a positive correlation with LSaO2 （r 〉 0, P 〈 0.01）, PRL and P values showed negative correlation （r 〈 0, P 〈 0.01）. Conclusion FSH, LH, PRL, E2, P and TT have cor relation with risk of OSAHS, and the menopause, hypertension, neck circumference and BMI were risk factors of OSAHS.