快动眼期呼吸暂停低通气指数在轻度阻塞性睡眠呼吸暂停低通气综合征病情评估中的意义

Significance of rapid-eye-movement apnoea-hypopnea index for the evaluation of the mild obstructive sleep apnoea-hypopnea syndrome

目的选取多导睡眠呼吸监测(polysomnogram,PSG)中评价轻度阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者病情轻重的合适指标,并探讨其对轻度OSAHS患者病情评估的意义。方法收集2016年1月—2020年12月就诊于中国人民解放军北部战区总医院耳鼻咽喉头颈外科经PSG检查符合轻度OSAHS的患者共166例,分别记录PSG各项指标及爱泼沃斯嗜睡量表(Epworth sleepiness score,ESS)、匹茨堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)评分,分析PSG中各项指标与各量表评分的相关性,并选取相关性强的指标进行相应的分组分析。结果ESS评分与快动眼期呼吸暂停低通气指数(rapid-eye-movement apnea-hypopnea index,REM-AHI)在2种相关性检验中均呈正相关关系(r=0.248、0.192,均P<0.05);MoCA评分与REM-AHI在2种相关性检验中均呈负相关关系(r=-0.260、-0.201,均P<0.05)。REM-AHI分组中各组间ESS评分、PSQI评分、MoCA评分比较差异均有统计学意义(均P<0.05);而最低血氧饱和度(lowest saturation oxygen,LSO2)分组中各组间ESS评分、PSQI评分、MoCA评分比较差异均无统计学意义(均P>0.05)。结论REM-AHI作为评估轻度OSAHS患者病情轻重的指标有着比LSO2等指标更为重要的意义,尤其是REM-AHI呈现中、重度的患者,其对机体的损害高于一般的轻度OSAHS患者。

Objective To select the appropriate index in polysomnogram(PSG)to evaluate the severity of patients with mild obstructive sleep apnoea-hypopnea syndrome(OSAHS)and explore its significance in evaluating the patients with mild OSAHS.Methods A total of 166 patients with mild OSAHS from General Hospital of Northern Theater Command from January 2016 to December 2020 were examined by PSG.Every index in the PSG and the results of Epworth sleepiness score(ESS),Pittsburgh sleep quality index(PSQI)and Montreal cognitive assessment(MoCA)were recorded,and the correlation between them was analysed.Strong relevance indexes were selected,and the groups were compared based on the index values.Results The correlation between ESS and rapid-eye-movement apnoea-hypopnea index(REM-AHI)was positive in the two correlation tests(r=0.248,0.192,both P<0.05),and that between the MoCA score and REM-AHI was negative(r=-0.260,-0.201,both P<0.05).The comparison of ESS,PSQI and MoCA results among the REM-AHI groups were all statistically significant(all P<0.05),but the comparison among the lowest-saturation-oxygen(LSO2)groups showed no statistically significant results(all P>0.05).Conclusion REM-AHI is more meaningful for the evaluation of the severity of mild OSAHS than other indexes such as LSO2.In particular,mild OSAHS patients with moderate-to-severe REM-AHI suffer from more damage to their bodies than the general ones.