不同海拔地区OSAHS患者呼吸紊乱情况初步探讨

Preliminary study on respiratory disturbance in patients with obstructive sleep apnea at different altitude

目的比较不同海拔地区（克拉玛依海拔500m，昆明海拔1800m）OSAHS患者呼吸紊乱、夜间低氧及白天血气情况。方法同期选择年龄、性别相匹配的克拉玛依市区OSAHS患者（114例）和昆明市区OSAHS患者（174例），选择年龄、性别相匹配的克拉玛依市区汉族（）sAHs（42例）和维吾尔族0sAHS患者（38例），比较组间睡眠呼吸紊乱和白天血气情况。结果昆明市区和克拉玛依市区睡眠呼吸暂停患者组间在呼吸暂停指数[（52．2±28．3）／hVS（35．7±23．1）／h]、氧减指数[（55．1±29．4）／hVS（33．5±19．9）／h]、PaO2[（76．0±17．9）mmHgvs（85．5±15．9）mmHg]、PaCOz[（33．5±7．4）mmHgVS（40．8±5．7）mmHg]等方面差异均有统计学意义（均P〈0．05）。维吾尔族0SAHs患者体质量指数、颈围、腹围、呼吸暂停指数、氧减指数均高于汉族OSAHS患者，其白天PaO2低于汉族OSAHS患者[（76．0±17．9）mmHgVS（84．4±15．3）mmHg]、PaCO2高于汉族[（43．1±5．5）mmHgVS（40．5±5．6）mmHg]（均P〈0．05）。结论睡眠呼吸紊乱与海拔、民族有关，高海拔可引起OSAHS患者白天PaO2及PaCO2下降，与呼吸调节功能有关。

Objective To analysis the respiratory disturbance in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS） in Karamaycity （altitude 500 m） and Kunming city （altitude 1 800 m）.Methods 288 subjects （114 cases of OSAHS from Karamay city and 174 cases of OSAHS from Kunming city） were underwent respiration and pulse oximeter tests. Apnea-hypopnea index （AHI）, hypopnea index （HI）, mean SaO2 （MSaO2% ）, the lowest SaO2 （LSaO2 % ）, the time spent at SaO2 below 90%,the number of desaturations≥ 4% per hour （ODL） were calculated at different altitude district （Karamay city altitude 500 m and Kunming city altitude 1 800 m）. The two groups were matched age, gender, body mass index （BMI）. We selected 42 cases OSAHS of Han nationlity and 38 cases OSAHS of Uyghur nationlity from Karamay city. The two groups were matched for age and gender. Results The AHIE（52.7±28.3）/h vs （33.1±19.9）/h],ODI4[（55.1±29.4）/h vs （33.5±19.9）/h],The MSaO2 [（86.1±10.1）% vs （90.6±7.3）%],the LSaO2 [（65.3±25.6）% vs （72.4±12.4）%],The arterial oxygen partial pressure （PaO2） [（61.4 ± 12.9） mmHg vs （83.3 ± 15.8） mmHg] and arterial carbon dioxide partial pressure （PaCO2） [（33.5 ± 7.4） mmHg vs （40.8 ± 5.7） mmHg] were significant difference between Kunming and Karamay＇ s OSAHS groups （all P〈0.05 ）. The PaO2 [（76.0 ± 17.9）mmHg vs （85.5±15.9） mmHg] and PaCO2 [（43.1±5.5） mmHg vs （40.5±5.6） mmHg] were significant difference between Han Nationality and Uyghur Nationality OSAHS groups （both P 〈0.05）. Conclusions Sleep disorder breathing were related to different altitude and nationality, the high altitude may induce the PaO2 and PaCO2 of OSAHS during the daytime, which may be attribute to the function of respiratory control.