阻塞性睡眠呼吸暂停低通气综合征发生日间高碳酸血症的相关因素分析

Analysis of the related factors of daytime hypercapnia in obstructive sleep apnea hypopnea syndrome patients

目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者发生日间高碳酸血症的相关因素。方法选取2018年10月-2019年5月在徐州医科大学附属医院睡眠监测中心就诊的68例OSAHS患者,其中高碳酸血症OSAHS组22例,非高碳酸血症OSAHS组46例。比较2组患者的一般资料、动脉血气分析和多导睡眠图相关指标,并对动脉血二氧化碳分压(PaCO2)与相关指标进行相关性分析。结果高碳酸血症OSAHS组患者的体重指数(BMI)、颈围、胸围、腰围、臀围和爱泼沃斯思睡量表(ESS)评分、PaCO2均明显高于非高碳酸血症OSAHS组(P<0.05或P<0.01),高碳酸血症OSAHS组动脉血氧分压(PaO2)、平均血氧饱和度(MSaO2)、HCO3-低于非高碳酸血症OSAHS组,差异有统计学意义(P<0.05或P<0.01)。PaCO2与BMI、颈围、胸围、腰围、臀围、ESS评分、HCO3-和MSaO2呈正相关(P<0.05),PaCO2与PaO2呈负相关(P<0.05)。结论OSAHS患者发生日间高碳酸血症与BMI、中心性肥胖、MSaO2有关。因此当OSAHS患者BMI、ESS评分升高、MSaO2降低时,应注意进行动脉血气分析检测,明确其有无日间高碳酸血症。

Objective To analyze the related factors of daytime hypercapnia in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 22 patients with OSAHS who were admitted into the Affiliated Hospital of Xuzhou Medical University from October 2018 to May 2019 were selected.They were divided into two groups:a hypercapnia OSAHS group(n=22)and a non-hypercapnia OSAHS group(n=46).The two groups were compared for general information,arterial blood gas analysis and polysomnography related indicators.Furthermore,the correlation between partial pressure of carbon dioxide in artery(PaCO2)and related indicators was analyzed.Results OSAHS patients with hypercapnia showed remarkable decreases in body mass index(BMI),neck circumference,chest circumference,waist circumference,hip circumference,Epworth sleepness scale(ESS)scores,and PaCO2 compared with the non-hypercapnia OSAHS group(P<0.05 or P<0.01).However,the hypercapnia OSAHS group had significantly lower partial pressure of oxygen in artery(PaO2),mean arterial oxygen saturation(MSaO2),and HCO3-than the nonhypercapnia OSAHS group(P<0.05 or P<0.01).PaCO2 was positively correlated with BMI,neck circumference,chest circumference,waist circumference,hip circumference,ESS scores,HCO3-and MSaO2(P<0.05),and PaCO2 was significantly negatively correlated with PaO2(P<0.05).Conclusions Daytime hypercapnia in patients with OSAHS is associated with BMI,central obesity,and MSaO2.Therefore,more attention should be paid for OSAHS patients with elevated BMI and ESS scores,and decreased MSaO2.The patients should be tested for arterial blood gas analysis to determine the presence of daytime hypercapnia.