孕早中期阻塞性睡眠呼吸暂停患者生命质量的现状及影响因素分析

A study on the current status and influencing factors of the quality of life in patients with obstructive sleep apnea during the first and second trimester of pregnancy

目的 探讨阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)对妊娠期女性生命质量(quality of life, QOL)的影响。方法 选取2020年9月至2022年3月首都医科大学附属北京妇产医院单胎孕早中期妊娠女性,根据睡眠呼吸暂停低通气指数(apnea hypopnea index, AHI),采用SF-36简明健康调查量表(简称SF-36量表)评估QOL。比较SF-36量表总分及各维度得分与睡眠监测各参数、BMI、年龄之间的相关性。结果 共纳入单胎孕早中期妊娠女性171例,年龄25~45岁,平均(34.0±3.9)岁。SF-36总分与非快速眼动期(non rapid eye movement, NREM)呼吸暂停最大时长呈负相关,躯体疼痛与NREM期呼吸暂停平均时长呈负相关,精力与最长氧减时间呈负相关。年龄对QOL影响不明显,但BMI与生理机能维度得分呈负相关。结论 OSA对妊娠期女性QOL均存在一定影响,肥胖能显著影响妊娠期OSA患者的QOL,临床医生在关注母婴并发症和结局的同时,更应关注其身心健康,并提供相应生活方式指导和心理干预;与AHI相比,呼吸暂停低通气持续时间对妊娠期OSA女性QOL影响更大,临床上可将AHI、最低血氧饱和度程度、呼吸暂停低通气持续时间综合考虑,为OSA患者评估提供一种新思路。

Objective To explore the effects of obstructive sleep apnea(OSA)on the quality of life(QOL)during the first and second trimester of pregnancy.Methods Women in the first and second trimester of singleton pregnancy in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from September 2020 to March 2022 were selected.QOL was assessed using the short form 36 health survey(SF-36)according to apnea hypopnea index(AHI).The relationship between the total score and each dimension score of SF-36 and the parameters of sleep monitoring,BMI and age were compared.Results A total of 171 women in the first and second trimester of singleton pregnancy were enrolled,aged from 25 to 45 years,with an average of(34.0±3.9)years.The total score of SF-36 was negatively correlated with the maximum duration of apnea during non rapid eye movement(NREM)sleep,bodily pain was negatively correlated with the average duration of apnea during NREM,and vitality was negatively correlated with the maximum oxygen deoxygenation time.Age had no significant effect on QOL,but BMI was negatively correlated with physical function.Conclusions OSA has a certain impact on QOL of pregnant women,and obesity can significantly affect QOL of pregnant women with OSA.Clinicians should attach more attention to QOL of OSA patients during pregnancy and provide corresponding lifestyle and psychological intervention,while paying attention to maternal and infant complications and outcomes.Compared with AHI,apnea hypopnea duration has a greater impact on QOL in pregnant women with OSA.In clinical practice,AHI,lowest oxygen saturation level and apnea hypopnea duration can be considered comprehensively to provide a new idea for the evaluation of OSA patients.