老年男性阻塞性睡眠呼吸暂停综合征患者发生衰弱的影响因素分析

Influencing factors for frailty in elderly male patients with OSAS

目的探讨老年男性阻塞性睡眠呼吸暂停综合征(OSAS)患者发生衰弱的影响因素。方法选择解放军总医院、甘肃中医药大学附属医院、北京大学人民医院、北京大学国际医院、北京朝阳医院和解放军第九六〇医院睡眠中心经多导睡眠监测诊断为OSAS的老年男性患者716例,按照衰弱筛查量表评分分为非衰弱组519例和衰弱组197例。比较非衰弱组与衰弱组多导睡眠监测及实验室各指标的差异。采用多因素Cox分析老年男性OSAS患者发生衰弱的相关影响因素。结果与非衰弱组比较,衰弱组年龄、吸烟、冠心病、脑血管病、颈动脉粥样硬化、消化性溃疡、外周血管病、慢性阻塞性肺病、肾功能不全、心功能不全、心房颤动、便秘、收缩压、LDL、红细胞分布宽度、暂停平均时间、暂停最长时间明显升高,TG、血小板计数、平均血饱和度、最低血氧饱和度明显降低,差异有统计学意义(P<0.05,P<0.01)。多因素Cox分析显示,年龄(95%CI:1.050~1.085,P=0.000)、颈动脉粥样硬化(95%CI:1.286~2.421,P=0.003)、便秘(95%CI:1.182~2.267,P=0.003)是老年男性OSAS患者发生衰弱的独立危险因素,血小板计数(95%CI:0.994~0.999,P=0.003)和平均血氧饱和度(95%CI:0.910~0.992,P=0.021)是老年男性OSAS患者发生衰弱的保护因素。结论老年男性OSAS患者衰弱发生率相对较高,年龄、颈动脉粥样硬化、便秘是老年男性OSAS发生衰弱的危险因素。

Objective To investigate the influencing factors of frailty among older male patients with OSAS.Methods A total of 716 elderly male patients with OSAS diagnosed with PSG in the sleep centers out of Chinese PLA General Hospital,Gansu TCM University Affiliated Hospital,Peking University People’s Hospital,Peking University International Hospital,Beijing Chaoyang Hospital and No.960 Hospital of PLA were recruited in this study.According to the results of FRAIL scale,519 patients were classified in the non-frailty group and 197 patients in the frailty group.The differences in PSG parameters and laboratory indicators were compared between the non-frailty and frailty groups.Multivariate Cox analysis was used to analyze the associated influencing factors of developing frailty in elderly male OSAS patients.Results Compared with the patients of the non-frailty group,those of the frailty group had older age,higher proportions of smoking,coronary heart diseases,cerebrovascular diseases,carotid atherosclerosis,peptic ulcer,peripheral vascular disease,chronic obstructive pulmonary disease,renal insufficiency,cardiac insufficiency,atrial fibrillation and constipation,higher systolic blood pressure and LDL level,wider red blood cell distribution width,longer average pause time,and prolongated maximum pause time,and obviously decreased TG level,platelet count,average blood saturation and minimum oxygen saturation(P<0.05,P<0.01).Multivariate Cox analysis indicated that age(95%CI:1.050-1.085,P=0.000),carotid atherosclerosis(95%CI:1.286-2.421,P=0.003)and constipation(95%CI:1.182-2.267,P=0.003)were independent risk factors for frailty,while platelet count(95%CI:0.994-0.999,P=0.003)and mean oxygen saturation(95%CI:0.910-0.992,P=0.021)were protective factors for frailty in elderly male OSAS patients.Conclusion The incidence of frailty is relatively high in older male OSAS patients.Age,carotid atherosclerosis,and constipation are risk factors for frailty in them.