体位性睡眠呼吸暂停患者的临床特点及其与低觉醒阈值的相关性研究

Clinical characteristics of patients with positional obstructive sleep apnea and their correlations with low arousal threshold

目的 探索体位性阻塞性睡眠呼吸暂停(positional obstructive sleep apnea, POSA)患者和非体位性阻塞性睡眠呼吸暂停(non-positional obstructive sleep apnea, NPOSA)患者的临床特点以及觉醒阈值差异。方法 收集因打鼾完善睡眠呼吸监测的患者,分析患者的临床数据、睡眠数据,计算低觉醒阈值情况。对POSA组和NPOSA组的数据进行比较。结果 在纳入的322例患者中,POSA患者占比为48.8%。POSA组的体质量指数(body mass index, BMI)呼吸暂停低通气指数(apnea-hypopnea index, AHI)和CT90占比显著低于NPOSA组(26.3 vs. 27.2,P=0.02;23.2 vs. 56.2,P<0.001;1.8 vs. 4.9,P=0.044),最低及平均血氧饱和度显著高于NPOSA组(82.0 vs. 79.0,P=0.038;95.0 vs. 94.1,P=0.019)。此外,POSA组中低觉醒阈值患者占比显著高于NPOSA组(29.3%vs. 8.5%,P<0.001)。结论 POSA患者的BMI和AHI低于NPOSA患者。低觉醒阈值可能在POSA的发生发展中起一定作用。

Objective To evaluate the clinical features and arousal threshold of patients with positional and non-positional obstructive sleep apnea.Methods All patients who underwent polysomnography(PSG)were enrolled,their demographic and polysomnographic data were collected,and arousal thresholds were calculated.These data were compared between the positional obstructive sleep apnea(POSA)and non-positional obstructive sleep apnea(NPOSA)groups.Results Among all the 322 patients with OSA,the prevalence of POSA was 48.8%.Patients with POSA had lower BMI,AHI and CT90(26.3 vs.27.2,P=0.02;23.2 vs.56.2,P<0.001;1.8 vs.4.9,P=0.044),as well as higher lowest and average oxygen saturation(82.0 vs.79.0,P=0.038;95.0 vs.94.1,P=0.019)compared to patients with NPOSA.Furthermore,a higher percentage of patients with POSA had a low arousal threshold compared to patients with NPOSA(29.3%vs.8.5%,P<0.001).Conclusion POSA was associated with lower BMI and AHI.Low arousal threshold may play a role in the development of positional OSA.