体重指数对高龄阻塞性睡眠呼吸暂停综合征患者的影响及其临床特征

The effect of body mass index on elderly patients with obstructive sleep apnea syndrome and its clinical characteristics

目的分析体重指数对高龄阻塞性睡眠呼吸暂停综合征患者(OSA)的影响及其临床特征。方法回顾性分析2018年10月17日至2020年8月31日于解放军总医院第一医学中心呼吸与危重症医学科睡眠呼吸监测中心就诊的年龄≥80岁的患者病历资料;统计参数包括呼吸事件指数、氧减指数、低于90%血氧饱和度时间占比、身高、体质量、出院诊断、死亡诊断等人口特征学信息。结果共纳入121例80岁以上的高龄住院患者。以呼吸事件指数分别≥5和≥15为诊断标准,OSA的患病率分别为91.7%(111例)和67%(82例),而临床出院诊断率仅有34.2%。合并症中,超重组(体重指数≥24 kg/m^(2))OSA患者在缺氧的时间比例上比非超重组(体重指数<24 kg/m^(2))OSA患者更高(P=0.012),但超重组和非超重组在OSA严重程度上差异无统计学意义(P=0.796)。出院诊断中,死亡患者中第一位死因为肺部感染。结论高龄患者的OSA诊断率较低,超重的高龄OSA患者面临更大的低氧风险,肺部感染在高龄OSA患者中可能是导致死亡的首要原因。

Objective To analyze the effect of body mass index on elderly patients with obstructive sleep apnea syndrome and its clinical characteristics.Methods From October 17,2018 to August 31,2020,the patients who had been tested at the sleep respiratory monitoring center of respiratory and critical medical department of the first medical center of PLA General Hospital were investigated.The statistical parameters included respiratory event index(REI),oxygen reduction index(ODI),time proportion of less than 90%oxygen saturation,height,weight,discharge diagnosis,death diagnosis and other demographic information.Results A total of 121 patients over 80 years old were included.Taking REI≥5 and≥15 as diagnostic criteria,the prevalence of OSA was 91.7%(111 cases)and 67%(82 cases),respectively.The clinical discharge diagnosis rate of OSA was only 34.2%.Overweight patients(BMI≥24kg/m^(2))group had a higher proportion of hypoxia time than non-overweight(BMI<24 kg/m^(2))group(P=0.012),but there was no difference in the severity of OSA between the two groups(P=0.796).In discharge diagnosis,pulmonary infection was the first cause of death.Conclusions The diagnosis rate of OSA in super-elderly patients is underestimated.Overweight super-elderly patients with OSA are at greater risk of hypoxia.Pulmonary infection may be the leading cause of death in super-elderly patients with OSA.