阻塞性睡眠呼吸暂停患者MAD、LAD及睡眠结构与病情严重程度的关系

Relationship of MAD and LAD with sleep structure and disease severity in patients with obstructive sleep apnea-hypopnea syndrome

目的:探讨阻塞性睡眠呼吸暂停(Obstructive sleep apnea-hypopnea syndrome,OSAHS)患者平均呼吸暂停持续时间(Mean apnea duration,MAD)、最长呼吸暂停持续时间(Longest apnea duration,LAD)及睡眠结构与病情严重程度的关系。方法:收集我院2021年7月至2022年7月收治的102例睡眠呼吸暂停患者临床资料。统计分析患者一般情况及睡眠呼吸监测结果,根据中华医学会OSAHS诊治指南将患者分为轻度组(n=18)、中度组(n=33)、重度组(n=51),对比三组一般情况及睡眠呼吸监测结果、各睡眠阶段的呼吸暂停低通气指数(Apnea-hypopnea index,AHI)值,并采用pearson分各因素或指标与AHI值的相关性。结果:轻度OSAHS组患者体质量、AHI值、MAD值、LAD值均低于中度组(P<0.05),中度组上述指标均低于重度组(P<0.05),轻度组非快速动眼的N3期在总睡眠时长的占比较中度组高(P<0.05),中度组较重度组高(P<0.05);体质量、MAD值、LAD值均与AHI值呈正相关关系(P<0.05),N3期占比与AHI值呈负相关关系(P<0.05);轻度OSAHS组各睡眠阶段的AHI值均较中度组低(P<0.05),中度组较重度组低(P<0.05),且三组患者N3期AHI值均低于同组其他各睡眠阶段(P<0.05)。结论:OSAHS患者MAD、LAD可能因为适应机制随着病情加重延长,且病情越重N3期时长占比越小,AHI值越小,考虑可通过延长N3期时长降低AHI。

Objective:To explore the relationship of mean apnea duration(MAD)and longest apnea duration(LAD)with sleep structure and disease severity in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods:Clinical data of 102 patients with OSAHS who were treated in the hospital from July 2021 to July 2022 were retrospectively analyzed.The general condition and sleep breathing monitoring results of the patients were statistically analyzed,and the patients were divided into mild group(n=18),moderate group(n=33)and severe group(n=51)according to the guidelines for diagnosis and treatment of OSAHS of Chinese Medical Association.The general condition,sleep breathing monitoring results and apnea-hypopnea index(AHI)at each sleep stage were compared among the three groups,and pearson analysis was used to analyze the correlation between each factor or indicator and AHI.Results:Body mass,AHI,MAD and LAD of patients in mild OSAHS group were lower than those in moderate group(P<0.05),and the above indicators in moderate group were lower than those in severe group(P<0.05).The proportion of N3 stage of non-rapid eye movement(NREM)in total sleep duration was higher in mild OSAHS group than that in moderate group(P<0.05)and was higher in moderate group than that in severe group(P<0.05).Body mass,MAD and LAD were positively correlated with AHI(P<0.05),and the proportion of N3 stage was negatively correlated with AHI(P<0.05).The AHI at each sleep stage in mild OSAHS group was lower than that in moderate group(P<0.05),and that in moderate group was also lower than severe group(P<0.05),and the AHI at N3 stage in the three groups was lower than that at other sleep stages(P<0.05).Conclusion:MAD and LAD in patients with OSAHS may be prolonged with the exacerbation of disease due to the adaptive mechanism.The more severe the disease,the lower the proportion of N3 stage and the lower the AHI.It is considered to prolonging the duration of N3 stage so as to reduce the AHI.