阻塞性睡眠呼吸暂停低通气综合征对眼表的影响

Effect of obstructive sleep apnea hypopnea syndrome on ocular surface

目的分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)对眼表的影响。方法回顾性病例对照研究。选取甘肃省人民医院2023年1月至5月行多导睡眠监测者60例。根据睡眠呼吸暂停低通气指数(AHI)将患者分为正常组、轻度OSAHS组、中度OSAHS组及重度OSAHS组4组, 每组15例。患者均进行眼表疾病指数(OSDI)问卷、裂隙灯检查、Keratograph 5M行非侵入性泪膜破裂时间(NIBUT)和睑板腺功能检查及泪液分泌试验(SⅠt)。结果轻度OSAHS组、中度OSAHS组及重度OSAHS组患者OSDI评分及睑板腺评分显著升高, 与正常组相比差异具有统计学意义(OSDI评分:t=2.47、7.36、11.24, 均P<0.05;睑板腺评分:t=2.01、2.38、2.95, 均P<0.05), 中度OSAHS组及重度OSAHS组患者NIBUT明显缩短、SⅠt减少, 与正常组相比差异具有统计学意义(NIBUT:t=2.24、2.89, 均P<0.05;SⅠt:t=2.82、3.29, 均P<0.05)。AHI值与NIBUT、SⅠt呈负相关(r=-0.28、-0.23, 均P<0.05), 与OSDI评分、睑板腺评分呈正相关(r=0.36、0.29, 均P<0.05)。结论 OSAHS患者泪液分泌减少、NIBUT缩短, 并伴有OSDI和睑板腺评分的升高。OSAHS引起干眼, 且严重程度与OSAHS严重程度相关。

Objective To investigate the effect of obstructive sleep apnea hypopnea syndrome(OSAHS)on ocular surface.Methods This was a retrospective case-control study.Sixty patients from Jan.to May 2023 in Gansu Provincial People’s Hospital were studied.Based on the sleep apnea hypopnea index(AHI),the patients were divided into four groups:the normal group,the mild OSAHS group,the moderate OSAHS group and the severe OSAHS group,with 15 cases in each group.Ocular surface disease index(OSDI)questionnaire,slit lamp and Keratograph 5M were used to examine non-invasive tear film rupture time,meibomial gland function,and for SchirmerⅠtest(SⅠt)in all patients.Results The OSDI score and meibomian gland score of the mild OSAHS group,the moderate OSAHS group and the severe OSAHS group significantly increased compared with those of the normal group(OSDI score:t=2.47,7.36,11.24;all P<0.05;Meibomian gland score:t=2.01,2.38,2.95;all P<0.05),and NIBUT significantly shortened and SⅠt decreased in the moderate OSAHS group and the severe OSAHS group compared with those in the normal group(NIBUT:t=2.24,2.89;all P<0.05;SⅠt:t=2.82,3.29;all P<0.05).AHI was negatively correlated with NIBUT and SⅠt(r=-0.28,P<0.05;r=-0.23,P<0.05),but positively correlated with OSDI score and meibomian gland score(r=0.36,P<0.05;r=0.29,P<0.05).Conclusion Patients with OSAHS have decreased tear secretion,shortened tear film rupture time,and increased OSDI and meibomian gland score.OSAHS causes dry eye,and the severity is correlated with OSAHS severity.