老年不同程度OSAHS合并高血压患者多导睡眠监测指标、血氧饱和度的变化及临床意义

Changes and clinical significance of polysomnography monitoring indexes and blood oxygen saturation in elderly patients with different degrees of obstructive sleep apnea hypopnea syndrome complicated with hypertension

目的探讨老年不同程度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)合并高血压患者多导睡眠监测指标、血氧饱和度的变化及临床意义。方法选择2020年2月至2021年2月在西安高新医院治疗的106例OSAHS合并高血压患者为研究对象,依据睡眠呼吸暂停低通气指数(AHI)分为轻度组(33例)、中度组(34例)及重度组(39例)。比较各组患者间的多导睡眠监测指标[最长呼吸暂停时间(LAX)、氧减指数(ODI)、平均血氧饱和度(MSaO_(2))、最低血氧饱和度(LSaO_(2))、快动眼睡眠(RME)与睡眠分期(N1、N2、N3)在总睡眠时间(TST)中的比值、呼吸相关微觉醒指数(RRMAI)]及血氧饱和度。结果重度组患者的LAX、ODI分别为(59.72±24.03)min、(45.81±22.51)次/h,明显高于中度组的(33.84±18.94)min、(19.36±14.72)次/h与轻度组的(25.96±15.93)min、(11.04±7.93)次/h,MSaO_(2)、LSaO_(2)分别为(92.65±3.42)%、(74.95±7.11)%,明显低于中度组的(95.89±2.01)%、(96.85±1.03)%与轻度组的(85.78±5.16)%、(85.24±8.03)%,差异均具有统计学意义(P<0.05);重度组患者的N1%、RRMAI、MAI分别为53.13±20.25、42.03±15.04、(49.45±18.63)次/h,明显高于中度组的37.36±14.81、14.85±9.57、(25.95±13.91)次/h与轻度组的19.94±12.74、6.83±2.11、(19.03±4.89)次/h,RME、N2%、N3%分别为13.01±5.89、30.63±13.94、2.66±3.01,明显低于中度组的14.25±6.83、40.63±11.04、5.92±4.74与轻度组的18.35±4.79、53.63±10.03、9.03±8.36,差异均具有统计学意义(P<0.05)。结论老年不同程度OSAHS合并高血压患者通过多导睡眠监测显示出睡眠片段化与睡眠结构紊乱,而且重度OSAHS合并高血压患者的最低血氧饱和度较低,是诊断老年不同程度OSAHS合并高血压的有效方式。

Objective To investigate the changes and clinical significance of polysomnography monitoring indexes and blood oxygen saturation in elderly patients with different degrees of obstructive sleep apnea hypopnea syndrome(OSAHS)complicated with hypertension.Methods A total of 106 patients with OSAHS and hypertension who were treated in Xi'an High-tech Hospital from February 2020 to February 2021 were selected as the research objects.According to the sleep apnea hypopnea index(AHI),they were divided into mild group(33 cases),moderate group(34 cases),and severe group(39 cases).Polysomnography monitoring indicators[maximum apnea time(LAX),oxygen decrement index(ODI),mean oxygen saturation(MSaO_(2)),minimum oxygen saturation(LSaO_(2)),ratio of rapid eye movement sleep(RME)to sleep stages(N1,N2,N3)in total sleep time(TST),respiration related micro-arousal index(RRMAI)]and oxygen saturation were compared among the three groups.Results The LAX and ODI of the severe group were(59.72±24.03)min and(45.81±22.51)times/h,which were significantly higher than(33.84±18.94)min and(19.36±14.72)times/h in the moderate group and(25.96±15.93)min and(11.04±7.93)times/h in the mild group;MSaO_(2) and LSaO_(2) were(92.65±3.42)%and(74.95±7.11)%,significantly lower than(95.89±2.01)%and(96.85±1.03)%in the moderate group and(85.78±5.16)%and(85.24±8.03)%in the mild group;the differences were statistically significant(P<0.05).N1%,RRMAI,and MAI in severe group were 53.13±20.25,42.03±15.04,(49.45±18.63)times/h,significantly higher than 37.36±14.81,14.85±9.57,(25.95±13.91)times/h in moderate group and 19.94±12.74,6.83±2.11,(19.03±4.89)times/h in mild group;RME,N2%,N3%were 13.01±5.89,30.63±13.94,2.66±3.01,respectively,which were significantly lower than 14.25±6.83,40.63±11.04,5.92±4.74 in moderate group and 18.35±4.79,53.63±10.03,9.03±8.36 in mild group;the differences were statistically significant(P<0.05).Conclusion Polysomnography in patients with different degrees of OSAHS and hypertension showed sleep fragmentation and sleep structure disturbances,and the minimum blood oxygen saturation of patients with severe OSAHS and hypertension was low.Polysomnography is effective in diagnosing different degrees of OSAHS and hypertension in the elderly.