维吾尔族及汉族睡眠呼吸暂停低通气综合征患者无创通气治疗压力及其相关因素

Noninvasive ventilation pressure and related factors in Uygur and Han patients with sleep apnea hypopnea syndrome

目的分析维吾尔族及汉族阻塞性睡眠呼吸暂停低通气综合征(OSA)患者夜间无创通气治疗的压力情况及其相关影响因素。方法选取行呼吸监测和调压治疗的109例OSA患者,体检包括身高、体重、颈围和腹围,夜间行睡眠监测和血氧监测,监测指标包括呼吸暂停指数(AHI)、低通气指数(HI)、氧减饱和指数(ODI4),平均氧饱和度(MSaO_(2))、最低氧饱和度(LSaO_(2))。夜间压力滴定监测患者夜间无创通气治疗最低压力(Min pressure)、最高压力(Max pressure)和90%的压力可信范围区间(P90)。结果汉、维吾尔族OSA患者在体重指数、LSaO_(2)、腹围、ODI4差异有显著性(P<0.05)。汉族与维吾尔族患者Max pressure、Min pressure、预测公式得出的压力值(PCPAPL)、P90差异无统计学意义(P>0.05),汉族及维吾尔族OSA患者PCPAPL均低于P90,差异有统计学意义(P<0.05)。结论治疗压力与体重指数、颈围、腹围、LSaO2、ODI4呈正相关,维吾尔族患者较汉族肥胖、腹围更高,但所需治疗压力并不比汉族患者高,推测可能与颌面结构不同有关。

Objective To analyze the pressure conditions and related influencing factors of noninvasive ventilation therapy of nocturnal noninvasive ventilation in Uygur and Han patients with obstructive sleep apnea hypopnea syndrome(OSA).Methods A total of 109 OSA patients underwent respiratory monitoring and pressure regulation.The physical examination included height,weight,nick circumference and abdominal circumference.Sleep monitoring and blood oxygen monitoring were performed at night,monitoring measures included apnea index(AHI),hypopnea index(HI),oxygen desaturation index(ODI4),average oxygen saturation(MSaO_(2)),minimum oxygen saturation(LSaO_(2)).Night pressure titration was used to monitor the minimum pressure(Min pressure),maximum pressure(Max pressure)of patients with noninvasive ventilation at night and 90%pressure confidence range interval(P90).Results There were significant differences in body mass index,LSaO_(2),abdominal circumference and ODI4 between Han and Uygur OSA patients(P<0.05).There were no significant difference in max pressure,min pressure,pressure value derived from the prediction formula(PCPAPL)and P90 between Han and Uygur OSA patients(P>0.05).The PCPAPL of patients with OSA in Han and Uygur patients was lower than P90,the difference was statistically significant(P<0.05).Conclusions The treatment pressure is positively correlated with body mass index,neck circumference,abdominal circumference,LSaO_(2) and ODI4.Uygur patients are more obese and have higher abdominal circumference than Han patients,but the treatment pressure of Uygur patients is not higher than that of Han patients,which may be related to different maxillofacial structures.