阻塞性睡眠呼吸暂停低通气综合征患者429例中医体质危险要素分析

Analysis of traditional Chinese medicine constitution risk factors in 429 patients with obstructive sleep apnea hypoventilation syndrome

目的:分析阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与中医体质的相关性。方法:连续纳入就诊于北京大学人民医院呼吸睡眠中心的OSAHS患者,根据睡眠监测报告判断OSAHS患者病情严重程度,参照《中医体质分类与判定》标准对患者进行中医体质评估。运用Lasso回归方法筛选与OSAHS病情严重程度相关的中医体质变量,并进一步筛选出影响OSAHS特征体质的相关变量,将筛选出的这些临床危险因素与OSAHS相关睡眠监测指标进行建模,以估算这些危险因素的相对风险。结果:共收集429例临床资料完整的OSAHS患者数据。Lasso回归分析显示与OSAHS病情严重程度相关的危险因素为痰湿质。痰湿体质OSAHS患者的身体质量指数(BMI)、呼吸暂停低通气指数(AHI)、呼吸暂停指数(AI)水平显著高于非痰湿体质患者(P<0.05),平均脉搏血氧饱和度(MSpO_(2))、最低脉搏血氧饱和度(LSpO_(2))水平显著低于非痰湿体质患者(P<0.05)。进一步分析发现,身体沉重、腹部肥满松软、额部油脂分泌多、口黏、痰多是痰湿体质OSAHS的特征变量。结论:痰湿体质是OSAHS的相对危险因素;痰湿体质OSAHS患者病情较非痰湿体质更严重;身体沉重、腹部肥满松软、额部油脂分泌多、口黏、痰多等变量对痰湿体质OSAHS的辨识及诊疗具有预测性。

Objective:Analyze the correlation between obstructive sleep apnea hypopnea syndrome(OSAHS)and traditional Chinese medicine constitution.Methods:Continuous inclusion of OSAHS patients in the Respiratory Sleep Center of Peking University People’s Hospital,Using sleep monitoring reports to determine the severity of OSAHS patients’condition,According to the standard of Classification and Judgment of Traditional Chinese Medicine Constitution,evaluate the patient’s traditional Chinese medicine constitution.Using Lasso regression method to screen for traditional Chinese medicine constitution variables related to the severity of OSAHS,and further screen for relevant variables that affect the characteristic constitution of OSAHS.Model these clinical risk factors with OSAHS related sleep monitoring indicators to estimate the relative risk of these risk factors.Results:A total of 429 OSAHS patients with complete clinical data were collected.Lasso regression analysis showed that the risk factor associated with the severity of OSAHS is phlegm dampness.Phlegm damp OSAHS patients constitution of BMI,apnea-hypopnea index(AHI),apnea index(AI)were significantly higher than patients without phlegm-dampness constitution(P<0.05),The mean pulse oxygen saturation(MSpO_(2)),lowest pulse oxygen saturation(LSpO_(2))level was significantly lower than patients without phlegm-dampness constitution(P<0.05).Further analysis found that the characteristic variables of OSAHS with phlegm-dampness constitution include heavy body,plump and loose abdomen,excessive secretion of forehead oil,sticky mouth,and excessive phlegm.Conclusion:Phlegm dampness constitution is a relative risk factor for OSAHS;The condition of patients with phlegm-dampness constitution is more serious than those with non-phlegm-dampness constitution OSAHS;The variables such as heavy body,full and soft abdomen,excessive oil secretion in the forehead,sticky mouth,and excessive phlegm can predict the identification and diagnosis and treatment of phlegm-dampness constitution OSAHS.