阻塞性睡眠呼吸暂停综合征与中心性浆液性脉络膜视网膜病变的相关性研究

Relationship between obstructive sleep apnea syndrome and central serous chorioretinopathy

目的观察阻塞性睡眠呼吸暂停综合征(OSAS)与中心性浆液性脉络膜视网膜病变(CSC)的相关性。方法2016年10月至2018年12月于西安市第三医院眼科检查确诊的CSC患者50例(CSC组)和年龄、性别相匹配的健康体检者50名(对照组)纳入研究。根据病程,将CSC分为急性期、慢性期,分别为20、30例。两组受检者平均年龄(Z=1.125)、体重指数(BMI)(Z=0.937)比较,差异无统计学意义(P>0.05);CSC不同病程患者年龄(Z=1.525)、性别构成比(χ^2=0.397)、BMI(Z=1.781)比较,差异均无统计学意义(P>0.05)。采用Berlin问卷对CSC组、对照组受检者的OSAS患病风险进行评估;采用多导睡眠记录仪监测受检者呼吸暂停低通气指数(AHI)和夜间睡眠期间最低血氧饱和度(MOS)。OSAS诊断标准:有典型睡眠时打鼾、白天嗜睡,AHI(次/h)数值≥5。OSAS严重程度分级为轻度OSAS:5≤AHI<15;中度OSAS:15≤AHI<30;重度OSAS:AHI≥30。非正态分布的计量资料比较采用秩和检验;计数资料比较采用χ^2检验。OSAS与CSC之间的相关性采用Spearman相关性分析。结果CSC组、对照组受检者AHI分别为(17.46±3.18)、(15.72±4.48)次/h;MOS分别为(83.48±4.68)%、(87.40±3.82)%;诊断为OSAS者分别为36(72.00%,36/50)、13(26.00%,13/50)例。两组受检者AHI(Z=0.312)、MOS(Z=0.145)、OSAS发病率(χ^2=21.17)比较,差异均有统计学意义(P=0.028、0.001、<0.001)。急性、慢性CSC患者AHI分别为(15.95±3.02)、(18.47±2.92)次/h;MOS分别为(86.10±11.07)%、(81.73±4.58)%。不同病程者AHI(Z=0.134)、MOS(Z=0.112)比较,差异均有统计学意义(P=0.005、0.001)。Spearman相关性分析结果显示,OSAS与CSC呈正相关(r=0.312,P=0.031)。结论OSAS可能是CSC发病的危险因素。

Objective To observe the correlation between obstructive sleep apnea syndrome(OSAS)and central serous chorioretinopathy(CSC).Methods From October 2016 to December 2018,50 cases of CSC patients(CSC group)and 50 healthy people(control group)matched by age and sex who were diagnosed in the ophthalmological examination of Xi’an No.3 Hospital were included in the study.According to the course of the disease,CSC was divided into acute phase and chronic phase,with 20 and 30 cases respectively.The average age(Z=1.125)and body mass index(BMI)(Z=0.937)of the two groups were compared,and the difference was not statistically significant(P>0.05);the age of patients with different courses of CSC(Z=1.525)and gender composition ratio(χ2=0.397)and BMI(Z=1.781)were compared,the difference was not statistically significant(P>0.05).The Berlin questionnaire was used to assess the OSAS risk of subjects in the CSC group and the control group;polysomnography was used to monitor the apnea-hypopnea index(AHI)and minimum blood oxygen saturation(MOS)during night sleep.OSAS diagnostic criteria:typical sleep snoring,daytime sleepiness,AHI(times/h)value≥5.The severity of OSAS was classified as mild OSAS:5≤AHI<15;moderate OSAS:15≤AHI<30;severe OSAS:AHI≥30.Non-normally distributed measurement data were compared by rank sum test;count data were compared byχ^2 test.Spearman correlation analysis was performed on the correlation between OSAS and CSC.Results The AHI data in the CSC group and the control group were 17.46±3.18 and 15.72±4.48 times/h,respectively;the MOS were(83.48±4.68)%and(87.40±3.82)%,respectively;those diagnosed with OSAS were respectively 36(72.00%,36/50)and 13(26.00%,13/50)cases.AHI(Z=0.312),MOS(Z=0.145),and OSAS incidence(χ^2=21.17)were compared between the two groups of subjects,and the differences were statistically significant(P=0.028,0.001,<0.001).The AHI of acute and chronic CSC patients were 15.95±3.02 and 18.47±2.92 times/h;the MOS were(86.10±11.07)%and(81.73±4.58)%,respectively.There were statistically significant differences in AHI(Z=0.134)and MOS(Z=0.112)in patients with different course of disease(P=0.005,0.001).The results of Spearman correlation analysis showed that OSAS and CSC were positively correlated(r=0.312,P=0.031).Conclusion OSAS may be a risk factor for the onset of CSC.