阿尔茨海默病患者睡眠呼吸暂停综合征患病率及风险因素分析

Prevalence and risk factors of sleep apnea in patients with Alzheimer′s disease

目的分析阿尔茨海默病(Alzheimer′s disease,AD)患者睡眠呼吸暂停综合征(SAS)患病率及风险因素,为AD患者预防SAS提供理论依据。方法选取2019年1月至2022年09月四川省广安市人民医院神经内科收治的AD患者130例,根据患者是否并发SAS{呼吸暂停低通气指数(AHI)≥5次/h}分为对照组(不合并SAS)和观察组(合并SAS),对比两组打鼾、夜间憋醒、晨起口干情况及AHI及SaO2值,采用自制问卷及查阅患电子病历床收集AD患者临床资料,包括患者年龄、性别、体质量指数(BMI)、AD病程、烟酒史、有无神经性退行性病变等,采用单因素分析和logistic回归分析AD患者发生SAS的独立危险因素。结果130例AD患者中发生SAS 43例(33.08%),其中观察组打鼾、夜间憋醒、晨起口干比例及AHI值显著低于对照组(P<0.05);观察组SaO2值显著低于对照组(P<0.05);两组在年龄、AD病程、BMI、吸烟史、合并高血压、神经性退行性病变、PSQI评分及CDR评分间差异具有统计学意义(P<0.05);多因素logistic回归分析显示BMI≥28 kg/m^(2)、PSQI评分>16分、CDR评分≥2分是AD患者发生SAS的独立危险因素(P<0.05)。结论AD合并SAS的发生率较高,其危险因素主要为BMI≥28 kg/m^(2)、PSQI评分>16分、CDR评分,应定期进行多导睡眠监测,预防SAS的发生。

Objective To analyze the prevalence and risk factors of sleep apnea syndrome(SAS)in patients with Alzheimer′s disease(AD),and to provide theoretical basis for the prevention of SAS in AD patients.Methods A total of 130 AD patients admitted to the Department of Neurology of Guang′an People′s Hospital of Sichuan Province from January 2019 to September 2022 were selected and divided into control group(without SAS)and observation group(with SAS)according to whether the patients were complicated with SAS{AHI≥5 times/h}.Snoring,waking at night,dry mouth in the morning,AHI and SaO2 values were compared between the two groups.Clinical data of AD patients,including age,gender,body mass index(BMI),AD course,tobacco and alcohol history,and neurodegenerative diseases,were collected by self-made questionnaire and consulting the patient′s electronic medical record bed.Univariate analysis and logistic regression were used to analyze the independent risk factors for SAS in AD patients.Results Among 130 AD patients,43 cases(33.08%)of SAS occurred.The proportion of snoring,awakening at night,dry mouth in the morning and AHI value in the observation group were significantly lower than those in the control group(P<0.05).SaO2 value in observation group was significantly lower than that in control group(P<0.05).There were significant differences in age,duration of AD,BMI,smoking history,combined hypertension,neurodegenerative disease,PSQI score and PSQI score between the two groups(P<0.05).Multivariate logistic regression analysis showed that BMI≥28 kg/m^(2),PSQI score>16 points and CDR score≥2 points were independent risk factors for SAS in AD patients(P<0.05).Conclusion The incidence of SAS associated with AD is higher,and the main risk factors are BMI≥28 kg/m^(2),PSQI score>16 and CDR score.Polysomnosis monitoring should be performed regularly to prevent SAS.