PSG和血氧监测对阻塞性睡眠呼吸暂停低通气综合征患者病情的评估价值

Evaluation of the value of PSG and blood oxygenation monitoring in patients with OSAHS

目的探讨多导睡眠监测(PSG)和血氧监测对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者病情的评估价值。方法选取2015年1月至2016年1月在北京大学深圳医院呼吸内科确诊为OSAHS患者123例,依据睡眠呼吸暂停低通气指数(AHI)值将OSAHS患者分为轻度(AHI 5.0~14.9次/h)、中度(AHI>15.0~29.9次/h)、重度(AHI>30次/h)三组,在相同条件下同时对患者进行PSG监测和血氧监测,同时进行监测记录后分析数据。结果三组患者睡眠时间<90%(T90%)、快速眼球运动睡眠中血氧饱和度<90%的时间占该时间比例(REM-T90%)、非快速眼球运动睡眠中血氧饱和度<90%的时间占该时间比例(NREM-T90%)比较差异有统计学意义(P<0.05);轻度组患者T90%、REM-T90%、NREM-T90%参数显著低于中度组、重度组,差异有统计学意义(P<0.05);中度组患者T90%、REM-T90%、NREM-T90%参数显著低于重度组,差异有统计学意义(P<0.05);轻度组患者平均血氧饱和度(MSPO2)、最低血氧饱和度(LSPO2)指标显著高于中度组、重度组;轻度组患者血氧饱和度下降指数(ODI)指标显著低于中度组、重度组,差异有统计学意义(P<0.05);中度组患者MSPO2、LSPO2指标显著高于重度组;中度组患者ODI指标显著低于重度组,差异有统计学意义(P<0.05),以急性冠状动脉综合征患者心功能评定为因变量,以N末端前脑钠肽(NT-proBNP)含量、高敏C反应蛋白(hs-CRP)含量、肽素含量为自变量。进行统计分析后发现有统计学意义(Chi-Square检验,P<0.05),各自变量对应变量影响大小依次为:NREM-T90%(OR=3.857)、ODI(OR=3.065)、REM-T90%(OR=2.829)、T90%(OR=2.484)、LSPO2(OR=2.363)、MSPO2(OR=1.878)。结论PSG和血氧监测对OSAHS患者病情有较好的评估价值。

Objective:To evaluate the value of polysomnography(PSG)and blood oxygenation monitoring in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods:A total of 123 patients with OSAHS diagnosed in our hospital from January 2015 to January 2016 were selected.According to the apnea and hypopnea index(AHI),patients with OSAHS were classified as mild(AHI was 5.0~14.9 times/h),moderate(AHI>15~29.9 times/h),severe(AHI>30 times/h)3 groups,while monitoring the PSG and blood oxygen bracelet for each patient,analysis of data after stimultaneous monitoring and recording.Results:The differences were statistically significant when comparing the time to sleep<90%(T90%),the proportion of time with oxygen saturation<90%of that time in rapid eye movement sleep(REMT90%),and the proportion of time with oxygen saturation<90%of that time in non-rapid eye movement sleep(NREMT90%)in the three groups(P<0.05);the parameters of T90%,REMT90%and NREMT90%were significantly lower in the mild group than in the moderate and severe groups,and the differences were statistically significant(P<0.05);T90%,REMT90%and NREMT90%parameters of patients in the moderate group were significantly lower than those in the severe group,and the difference was statistically significant(P<0.05);the mean oxygen saturation(MSPO 2)and minimum oxygen saturation(LSPO 2)parameters were significantly higher in the mild group than in the moderate and the mean oxygen saturation(MSPO 2)and minimum oxygen saturation(LSPO 2)indexes of patients in the mild group were significantly higher than those in the moderate and severe groups,and the difference was statistically significant(P<0.05);MSPO 2 and LSPO 2 indicators were significantly higher in the moderate group than in the severe group;ODI indices were significantly lower in the moderate group than in the severe group,and the difference was statistically significant(P<0.05),with the assessment of cardiac function in patients with acute coronary syndrome as the dependent variable and the N-terminal pro-brain natriuretic peptide(NT pro-BNP)content,high-sensitivity C-reactive protein(hs-CRP)content,and peptide content were used as independent variables.Statistical analysis was performed and found to be statistically significant(Chi-Square test,P<0.05),with the respective variables corresponding to variable effect sizes in the following order:NREMT 90%(OR=3.857),ODI(OR=3.065),REMT90%(OR=2.829),T90%(OR=24.84),LSPO 2(OR=2.363),MSPO 2(OR=1.878).Conclusions:PSG and blood oxygenation monitoring have a good evaluation value for patients with OSAHS.