维吾尔族和汉族阻塞性睡眠呼吸暂停低通气综合征患者呼吸中枢低氧反应性损害及其影响因素

Impaired hypoxic ventilatory response and related factors in Han and Uygur patients with obstructive sleep apnea-hypopnea syndrome

目的探讨维吾尔族和汉族阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者呼吸中枢低氧反应性及其相关影响因素。方法收集2016年1—12月克拉玛依市中心医院呼吸与危重症医学科睡眠中心住院及门诊的166例OSAHS患者，其中汉族69例，男42例，女27例，年龄（50±9）岁；维吾尔族97例，男58例，女39例，年龄（52±8）岁；同期73名健康维吾尔族体检者73名（对照组），男49名，女34名，年龄（50±7）岁。所有受试者均经睡眠呼吸监测、夜间SaO2监测、肺功能及采用国际标准重复呼吸法测定呼吸中枢低氧反应性，计算Δ分钟通气量/Δ血氧饱和度（ΔVE/ΔSaO2）得到呼吸中枢低氧反应性。结果年龄、性别、体重指数和呼吸暂停指数相匹配的汉族与维吾尔族OSAHS患者组间的氧减指数分别为（30±22）和（24±19）次/h，ΔVE/ΔSaO2分别为（－0.41±0.23）和（－0.36±0.22）L·min－1·%－1，组间比较差异有统计学意义（P〈0.05）。轻度维吾尔族OSAHS患者ΔVE/ΔSaO2为（－0.31±0.21）L·min－1·%－1，明显低于汉族OSAHS患者[（－0.41±0.22）L·min－1·%－1，P〈0.05]，重度维吾尔族OSAHS患者的低氧通气反应性仍低于汉族，但差异无统计学意义。结论维吾尔族OSAHS患者呼吸中枢低氧反应性低于汉族OSAHS患者及正常值。

ObjectiveTo investigate the respiratory central hypoxia response and its related factors in Han and Uygur patients with obstructive sleep apnea hypopnea syndrome （OSAHS）.MethodsOne hundred and sixty six OSAHS patients were selected from Jan. 2016 to Dec. 2016 in Department of Respiratory and Critical Care Medicine, Kelamayi Central Hospital, including 69 cases of Han nationality and 97 cases of Uygur nationality. Seventy-three healthy subjects of Uygur nationality were enrolled as the control group. All of them under went sleep monitoring, nocturnal oxygen saturation （SaO2）, pulmonary function and respiratory central hypoxia response.ResultsThe 3 groups were matched for age, gender, body mass index（BMI） and apnea-hypopnea index（AHI）. The Uygur patients had a higher oxygen desaturation index （ODI4） [（30±22） per hour vs （18±17） per hour ] than Han patients of the same age and BMI. Compared to Han patients, Uygur patients had weaker hypoxic responsiveness [（-0.41±0.23） L·min-1·%-1 vs （-0.36±0.22） L·min-1·%-1,P〈0.05], and the difference still existed after adjusting for AHI [（-0.31±0.21） L·min-1·%-1 vs （-0.41±0.22） L·min-1·%-1,P〈0.05] in mild OSAHS, but this difference was not significant in severe OSAHS.ConclusionsThe central hypoxic response in Uygur OSAHS patients was lower than that in Han OSAHS patients and normal controls.