阻塞性睡眠呼吸暂停综合征与非动脉炎性前部缺血性视神经病变的相关性分析

Correlation between obstructive sleep apnea syndrome and nonarteritic anterior ischemic optic neuropathy

目的观察阻塞性睡眠呼吸暂停综合征(OSAS)与非动脉炎性前部缺血性视神经病变(NAION)的相关性。方法前瞻性研究。2016年12月至2018年12月在西安市第三医院眼科连续就诊的41例NAION患者(NAION组)以及年龄、性别与之匹配的41名健康体检者(对照组)纳入研究。采用多导睡眠记录仪对两组研究对象的呼吸暂停低通气指数(AHI)即每小时睡眠呼吸暂停的次数进行监测,同时持续记录研究对象的夜间血氧饱和度。若AHI数值≥5,即可诊断OSAS。OSAS病情分级为轻度:5≤AHI<15;中度:15≤AHI<30;重度:AHI≥30。两组患者的OSAS病情分级比较采用Fisher精确检验,AHI、夜间最小血氧饱和度比较采用Mann-WhitneyU检验。对OSAS与NAION之间的相关性进行Spearman相关性分析。结果NAION组中,被诊断为OSAS31例(75.61%)。其中,轻度6例(14.63%),中度9例(21.95%),重度16例(39.03%)。对照组中,被诊断为OSAS19例(46.34%)。其中,轻度10例(24.39%),中度5例(12.20%),重度4例(9.75%)。NAION组、对照组不同OSAS病情分级的患者数量比较,差异均有统计学意义(Z=0.235、0.245、0.312,P=0.012、0.014、0.032)。NAION组平均AHI为20.25±7.74,夜间平均最小血氧饱和度为(87.38±5.53)%。对照组平均AHI为18.67±11.67,夜间平均最小血氧饱和度为(85.06+4.25)%。NAION组、对照组平均AHI、夜间平均最小血氧饱和度比较,差异均有统计学意义(Z=1.124、2.317,P=0.003、0.020)。Spearman相关性分析结果显示,OSAS与NAION之间呈正相关(Spearman相关系数=0.229,P=0.030)。结论OSAS与NAION呈正相关。

Objective To determine the correlation between obstructive sleep apnea syndrome (OSAS) and nonarteritic ischemic optic neuropathy (NAION). Methods It was a perspective study. A total of 41 consecutive patients with NAION (NAION group) and 41 age- and sex-matched physical examination subjects (control group) in Xi’an No.3 Hospital from December 2016 to December 2018 were enrolled in this study. The apnea hypopnea index (AHI, the number of sleep apneas per hour) was monitored using a polysomnography for patients in NAION group and control group. At the same time, the blood oxygen saturation was continuously recorded. The OSAS can be diagnosed if the AHI value was ≥5. OSAS severity was graded as mild: 5≤AHI<15;moderate: 15≤AHI<30;severe: AHI ≥30. The grading of OSAS severity between two groups was compared by Fisher's exact test. The AHI and minimum blood oxygen saturation were compared between NAION group and control group using the Mann-Whitney U test. Spearman correlation analysis was performed on the correlation between OSAS and NAION. Results Among the patients in the NAION group, 31 patients (75.61%) were diagnosed with OSAS. Among them, 6 patients (14.63%) were mild, 9 patients (21.95%) were moderate, and 16 patients (39.03%) were severe. In the control group, 19 patients(46.34%) were diagnosed with OSAS. Among them, 10 patients (24.39%) were mild, 5 patients (12.20%) were moderate, and 4 patients (9.75%) were severe. The difference of OSAS patients of mild, moderate and severe between two groups were statistically significant (Z=0.235, 0.245, 0.312;P=0.012, 0.014, 0.032). The average AHI of patients in the NAION group was 20.25±7.74, and the mean minimum oxygen saturation at night was(87.38±5.53)%. The average AHI of the control group was 18.67±11.67, and the mean minimum oxygen saturation at night was (85.06+4.25)%. The differences of the mean AHI and mean minimum oxygen saturation between two groups were statistically significant (Z=1.124, 2.317, P=0.003, 0.020). There was a positive correlation between OSAS and NAION (Spearman correlation coefficient=0.229, P=0.030). Conclusion There is a positive correlation between OSAS and NAION.