应用PM筛查社区首诊高血压患者OSAHS患病情况及中医体质调查研究

Screening prevelance of OSAHS in hypertension patients first diagnosed in community by PM and research on constitution of TCM

目的 调查社区首诊高血压病患者合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的患病情况及其中医体质分布。方法 纳入2019年1月至2020年12月在丽水市3家社区卫生服务中心首次确诊的高血压患者,应用便携式睡眠呼吸监测仪(PM)筛查OSAHS。研究合并OSAHS的患者与单纯高血压患者在性别、年龄、吸烟史、家族打鼾史、体质量指数(BMI),爱泼沃斯嗜睡量表(ESS)评分方面的差异,调查患者中医体质分布。结果 确诊OSAHS患者401例(50.82%),男女发病率比较,差异无统计学意义(P>0.05),轻、中、重度3个OSAHS组患者男女构成比较,差异无统计学意义(P>0.05)。合并OSAHS组与单纯高血压组对比,平均年龄小于单纯高血压组(P<0.05),有家族打鼾史者高于单纯高血压组(P<0.05)。重度OSAHS组的BMI、ESS与轻度、中度组比较,差异有统计学意义(P<0.05)。轻度、中度、重度OSAHS合并高血压患者中医体质分布存在差异(χ^(2)=59.069,P<0.01)。痰湿质、湿热质为高血压合并OSAHS患者最常见的2种体质。通过本项目的实施,3家社区卫生服务中心医务人员对OSAHS相关知识的知晓率明显提高。结论 高血压合并OSAHS发病率高,应用PM进行OSAHS筛查简便、易推广,有利于推动基层医疗单位OSAHS诊治能力提升。

Objective To investigate the prevalence of obstructive sleep apnea-hypopnea syndrome(OSAHS) and distribution of traditional Chinese medicine constitution in patients with initially diagnosed hypertension in community.Methods Patients with initially diagnosed hypertension in three community health service centers in the Lishui city from January 2019 to December 2020 were included, and OSAHS was screened using portable monitors(PM). The gender, age, smoking history, family history of snoring, body mass index(BMI),and Epworth Sleepiness Scale(ESS)score were compared between patients with OSAHS and patients with simple hypertension,to investigate the distribution of traditional Chinese medicine constitution. Results There were 401 confirmed OSAHS patients(50.82%). There was no statistical difference in disease incidence between males and females(P>0.05). There were no statistical differences in the compositions of males and females among the mild, moderate,and severe OSAHS groups(P >0.05). The average age in the OSAHS group was smaller than that in the simple hypertension group(P<0.05).The proportion of patients with a family history of snoring in the OSAHS group was higher than that in the simple hypertension group(P<0.05).There were statistically significant differences in BMI and ESS between the severe OSAHS group and the mild and moderate groups(P<0.05).There was difference in distribution of TCM constitution among the mild,moderate,and severe OSAHS groups(χ^(2)=59.069,P<0.01).Phlegm-dampness and damp-heat were the two most common constitutions in patients with hypertension and OSAHS.Through the implementation of this project,the awareness rate of OSAHS-related knowledge among medical staff in the three community health service centers had increased significantly. Conclusion The incidence of hypertension combined with OSAHS is high. The application of PM for OSAHS screening is simple and easy to promote, which is beneficial to promote improvement of OSAHS diagnosis and treatment capabilities of primary medical units.