睡眠呼吸暂停低通气综合征患者病情的影响因素分析

Analysis for the influence factors of patients’ conditions in obstructive sleep apnea-hyponea syndrome

目的 分析睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hyponea syndrome,OSAHS)患者病情严重程度的影响因素。方法 收集2015 年1 月1 日~2018 年12 月31 日住院经多导睡眠监测仪诊断为OSAHS 患者88 例,其中重度患者73 例,轻-中度患者15 例;收集患者睡眠呼吸暂停低通气指数(apnea hypopnea index,AHI)、身高、颈围(neckcircumference,CN)、夜间最低动脉血氧饱和度(lowest oxygen saturation,LSaO2)、体重,计算体质指数(body mass index,BMI);收集患者入院生化常规检查中的尿酸(uric acid,UA)及肌酐值(creatinine,Cr),求尿酸/肌酐(UA/Cr)值;其中5≤AHI≤15为轻度,15<AHI≤30 为中度,AHI>30 为重度;对收集的计量资料进行多元线性回归分析、配对样本t 检验及独立样本t 检验。结果 BMI、CN 与OSAHS 患者的AHI 具有较好的线性相关性且呈正相关,UA/Cr 值与OSAHS 患者AHI 无线性相关关系,建立多元线性回归方程为:AHI=1.52×BMI+1.48×CN-54.70;理论预测值为53.34±10.34,实际值为53.51±12.58,经配对样本t 检验得t =0.08,P =0.91;重度组OSAHS 患者夜间睡眠动脉血LSaO2 为0.59±0.15,轻-中度组OSAHS 患者LSaO2为0.74±0.14,差异有统计学意义(P< 0.01);重度组OSAHS 患者UA/Cr 为5.42±0.95,轻-中度组OSAHS 患者UA/Cr 为4.83±0.86,差异有统计学意义(P =0.03)。结论 UA/Cr 值结合CN 及BMI 可以较好地反映OSAHS 患者的病情严重程度。

Objective To analyze the influence factors of patients' conditions in obstructive sleep apneahyponea syndrome. Methods 88 patients with obstructive sleep apnea-hyponea syndrome (OSAHS) diagnosed by polysomnography monitor in hospital from Jan 1, 2015 to Dec 31, 2018 were sellected, among which 73 patients were severe and 15 patients were mild to moderate. Collected the data of patients including apnea hyponea index (AHI), height and neck circumference (CN), night lowest oxygen saturation (LSaO2), weight, calculated body mass index (BMI). The uric acid (UA) and creatinine (Cr) values were collected from the biochemical routine examination, and the uric acid/creatinine (UA/Cr) values were calculated. Patients with AHI from 5 to 15 were mild, patients with AHI from 15 to 30 were moderate, and patients with AHI more than 30 were severe. Multiple linear regression, paired sample t test and independent sample t test were performed on the collected data. Results BMI and CN had a good linear correlation and positive correlation with AHI, while UA/Cr had no linear correlation with AHI in OSAHS patients. The multiple linear regression equation was established as follows: AHI=1.52×BMI+1.48×CN-54.70. The predicted value was 53.34±10.34, the actual value was 53.51±12.58 (t=0.08, P=0.91). LSaO2 in severe OSAHS patients was 0.59±0.15, LSaO2 in mild to moderate OSAHS patients was 0.74±0.14, the difference was significant (P<0.01). The UA/Cr of severe OSAHS patients was 5.42±0.95, the UA/Cr of mild to moderate OSAHS patients was 4.83±0.86, the difference was significant (P=0.03). Conclusion UA/Cr value combined with CN and BMI can better reflect the severity of OSAHS patients.