Meta-analysis of randomized controlled trials of traditional Chinese medicine in the treatment of obstructive sleep apnea syndrome

Objective:Though Chinese medicine(CM)has showed its clinical efficacy for the treatment of obstructive sleep apnea(OSA)in China,no systematic reviews or meta-analyses provide evidences for its therapeutic effects on OSA and the long-term safety.The aim of the present study is to evaluate the effectiveness and safety of CM on OSA using meta-analysis.Methods:We used search items of"Chinese Medicine"AND"obstructive sleep apnea"to retrieve the randomized control trials(RCTs)of CM treatments for OSA in PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),VIP database,and Wanfang database from their respective inception dates to December 2019.Only RCTs of CM therapy versus no treatment which could be quantitatively synthesized were included.Finally,20 studies representing 1,297 participants were included after extraction.Two investigators independently extracted and analyzed the data using RevMan5.3 software.Results:The treatment group using CM decoctions or CM granules presented significantly ameliorative effects on apnoea-hypopnoea index(AHI)compared with the control group(MD:-2.58,95%CI:-3.59 to-1.56,P<0.00001 and MD:-5.47,95%CI:-6.75 to-4.19,P<0.00001,respectively)in the sensitivity analysis.However,there were non significant differences in the duration of treatment between subgroups,indicating that the duration of treatment has no impacts on the therapeutic effects on AHI.CM granules also showed significantly ameliorative effects on the lowest nocturnal oxygen saturation(LSaO2)(MD:2.76,95%CI:1.85 to 3.68,P<0.00001).CM decoctions exhibited significantly improved Epworth Sleepiness Scale(ESS)scores compared with the control group in a sensitivity analysis(MD:-1.50,95%CI:-2.13 to-0.88,P<0.00001).CM granules showed a better improvement of ESS than the control group(MD:-1.35,95%CI:-1.92 to-0.78,P<0.00001).Mild adverse reactions occurred only in five patients and disappeared without special treatment.Conclusion:This study showed favorable therapeutic efficacy of CM on OSA.However,in consideration of the low methodological quality of the included RCTs,more rigorous designed,large sample size RCTs are recommended for providing more high-quality evidences.

Effect of obstructive sleep apnea on type 2 diabetes mellitus:A comprehensive literature review

Obstructive sleep apnea(OSA)is frequently associated with obesity and metabolic syndrome.Also frequently associated with metabolic syndrome is type 2 diabetes mellitus(T2DM).Therefore,it is common to find OSA and T2DM together in individuals with metabolic syndrome.Additionally,both OSA and T2DM have a common pathophysiological link with development of insulin resistance.Individuals with severe insulin resistance are likely to have inadequate glycemic control.Long standing poorly controlled T2DM is associated with debilitating microvascular complications such as retinopathy,nephropathy,neuropathy and macrovascular complications such as coronary artery and cerebrovascular disease.There is extensively published literature exploring the cause-effect relationship between OSA and T2DM.In this article we provide an in-depth review of the complex pathophysiological mechanisms linking OSA to T2DM.Specifically,this review focusses on the effect of OSA on the microvascular complications of T2DM such as retinopathy,nephropathy and neuropathy.Additionally,we review the current literature on the effect of continuous positive airway pressure use in individuals with T2DM and OSA.

Turbulent Kinetic Energy of Flow during Inhale and Exhale to Characterize the Severity of Obstructive Sleep Apnea Patient

This paper aims to investigate and present the numerical investigation of airflow characteristics using Turbulent Kinetic Energy(TKE)to characterize the upper airway with obstructive sleep apnea(OSA)under inhale and exhale breathing conditions.The importance of TKE under both breathing conditions is that it showan accuratemethod in expressing the severity of flow in sleep disorder.Computational fluid dynamics simulate the upper airway’s airflow via steady-state Reynolds-averaged Navier-Stokes(RANS)with k–ωshear stress transport(SST)turbulencemodel.The three-dimensional(3D)airway model is created based on the CT scan images of an actual patient,meshed with 1.29 million elements using Materialise Interactive Medical Image Control System(MIMICS)and ANSYS software,respectively.High TKE were noticed around the region after the necking(smaller cross-sectional area)during the inhale and exhale breathing.The turbulent kinetic energy could be used as a valuablemeasure to identify the severity of OSA.This study is expected to provide a better understanding and clear visualization of the airflow characteristics during the inhale and exhale breathing in the upper airway of patients for medical practitioners in the OSA research field.

Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

Polysomnographic findings of obstructive sleep apnea in children with adenotonsillar hypertrophy

Serous Background: There are few studies assessing the clinical manifestations of sleep breathing disorders and polysomnograms in several pediatric age ranges. This studied aimed to assess polysomnography results such as apnea-hypopnea index, mean oxygen saturation and sleep efficiency in children presenting with airway obstruction and adenotonsillar hypertrophy complaints, and to establish whether they are correlated to age and sex. Methods: A retrospective study with children of both sexes, aged between 2 and 12 years, with clinically suspected obstructive sleep apnea syndrome and adenotonsillar hypertrophy, who underwent polysomnography before surgery. The children were allocated to groups according to their age range (Group I: 2 to 4 years old;Group II: 5 to 8 years old;Group III: 9 to 12 years old). Apnea-hypopnea index, mean oxygen saturation and sleep efficiency data were compared between sexes and among the three groups (Student’s t test, p < 0.05). Results: Of 167 children studied by polysomnography, 76.6% were of school age and 67% were male. For all studied age ranges, there was no difference between sexes for the investigated parameters (body mass index, apnea-hypopnea index, mean oxygen saturation and sleep efficiency). As regards mean oxygen saturation, Group I showed the lowest value (89.9 ± 6.2). Apnea-hypopnea indexes were higher in male children aged between 2 and 4 years (9.9 ± 5.2). Group III had the lowest sleep efficiency (84.1 ± 9.2). Conclusion: There was a predilection of more severe cases of obstructive sleep apnea syndrome for children younger than four years, shown by higher apnea-hypopnea index per hour and lower mean oxygen saturation in this age range.

Gender Differences in Rapid Eye Movement-Related Sleep Disordered Breathing

Sleep disordered breathing (SDB) is an independent risk factor for cardiovascular disease. It is known to be associated more frequently with men than women, particularly in the premenopausal age range. The goal of this study is to evaluate gender differences among Korean patients diagnosed with SBD. This study included 309 patients who visited our Sleep Clinic due to sleep-related symptoms and were diagnosed with SDB by overnight polysomnography (PSG). We analyzed age, gender, body mass index, various PSG indices including sleep stages, apnea-hypopnea index (AHI) and AHI ratio in rapid eye movement (REM) versus non-REM (NREM) sleep stages (R:N ratio). Of those 309 patients diagnosed with obstructive sleep apnea, 217 (70.2%) were men (mean age 51.05 ± 12.64 years) and 92 (29.8%) were women (mean age 64.53 ± 10.43 years). The mean AHI during total sleep time was 30.34 ± 21.17 in men and 21.47 ± 17.14 in women (P P P = 0.402). REM SDB with R:N ratio higher than 2.0 was more frequently observed in women than in men, 34.8% (32/92) of women, compared with 11.9% (26/217) in men (P 60 years old. These findings suggest the possibility of different pathophysiologic mechanisms of SDB between genders and also between NREM versus REM sleep, which can be partly explained by the influence of female sex hormones.

Relationship between metabolic syndrome and hypercapnia among obese patients with sleep apnea Relationship between metabolic syndrome and hypercapnia among obese patients with sleep apnea

BACKGROUND In the obese patient population,some patients have severe obstructive sleep apnea(OSA)with daytime hypoventilation.Such patients are generally identified on the basis of the presence or absence of daytime hypercapnia,and the condition is called obesity hypoventilation syndrome.However,mechanisms for such daytime hypoventilation remain unclear.AIM To investigate metabolic syndrome and daytime hypercapnia association based on hypercapnia prevalence in obese OSA patients in a nested case-control study.METHODS Consecutive obese patients(body mass index≥30 kg/m2)who underwent polysomnography due to suspected OSA were included.Among them,patients with severe OSA(apnea hypopnea index≥30/h)were divided into two groups according to the presence or absence of hypercapnia during wakefulness(arterial partial pressure of carbon dioxide≥or<45 Torr,respectively).The characteristics and clinical features of these two groups were compared.RESULTS Among 97 eligible patients,25 patients(25.8%)had daytime hypercapnia.There were no significant differences in age,gender,body mass index,apnea-hypopnea index,and Epworth Sleepiness Scale scores between the two groups.However,patients with hypercapnia had a significantly lower arterial partial pressure of oxygen level(75.8±8.2 torr vs 79.9±8.7 torr,P=0.042)and higher arterial partial pressure of carbon dioxide level(46.6±2.5 torr vs 41.0±2.9 torr,P<0.001).Additionally,patients with hypercapnia were more likely to have metabolic syndrome(72.0%vs 48.6%,P=0.043)and a higher metabolic score(the number of satisfied criteria of metabolic syndrome).In multivariate logistic regression analysis,the presence of metabolic syndrome was associated with the presence of hypercapnia(OR=2.85,95%CI:1.04-7.84,P=0.042).CONCLUSION Among obese patients with severe OSA,26%of patients had hypercapnia during wakefulness.The presence of metabolic syndrome was independently correlated with the presence of daytime hypercapnia.

Relationship between reduced nicotinamide adenine dinucleotide phosphate oxidase subunit p22phox gene polymorphism and obstructive sleep apnea-hypopnea syndrome in the Chinese Han population

Background Increased production of reactive oxygen species （ROS） is thought to play a major role in the pathogenesis of obstructive sleep apnea-hypopnea syndrome （OSAHS）. The reduced nicotinamide adenine dinucleotide phosphate （NADPH） oxidase complex is an important source of ROS. The p22phox subunit is polymorphic with a C242T variant that changes histidine-72 for a tyrosine in the potential heme binding site. This study aimed to investigate the relationship between NADPH oxidase subunit p22phox gene polymorphism and OSAHS. Methods The genotypes of p22phox polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphisms （PCR-RFLP） assay in 176 unrelated subjects of the Han population in southern region of China （including 107 OSAHS subjects and 69 non-OSAHS subjects）, while the plasma concentration of superoxide dismutase （SOD） was detected in the two groups, and p22phox mRNA expression in peripheral blood mononuclear cell （PBMC） was determined with reverse transcription polymerase chain reaction （RT-PCR）. Results The phagocyte NADPH oxidase subunit p22phox mRNA expression was significantly increased in the OSAHS group than that in the non-OSAHS group （P 〈0.01）. Compared with the non-OSAHS control group （（85.31±9.23） U/ml）, the levels of SOD were lower in patients with OSAHS （（59.65±11.61） U/ml （P 〈0.01）. There were significant differences in genotypes distribution in p22phox polymorphism between the two groups （P=0.02）. Compared with the non-OSAHS control group, the OSAHS group had a significantly higher T allele frequency in p22phox polymorphism （P=0.03）. There were independent effects of p22phox polymorphism on body mass index （BMI）, neck circumference （NC）, waist-to-hip ratio （WHR） in the OSAHS group, and the carriers of the T allele of p22phox polymorphism had greater NC, WHR, systolic blood pressure （SBP）, diastolic blood pressure （DBP） and apnea-hypopnea index （AHI） （P 〈0.05）, but the carriers of the T allele had lower SOD （P 〈0.01） and lowest SaO2 （P=0.04）. There was no significant difference in p22phox mRNA expression between the OSAHS groups with or without T allele （P=0.45）. Conclusions The NADPH oxidase subunit p22phox gene polymorphism may be associated with susceptibility to OSAHS, and it may be an important candidate gene for OSAHS.

Angiotensin Ⅰ-converting enzyme gene poly morphism in Chinese patientswith obstructive sleep apnea syndrome

Objective To investigate the relationship of an insertion/deletion (I/D) polymorphism of the angiotension converting enzyme (ACE) gene to obstructive sleep apnea syndrome (OSAS) patients and the control subjects.Methods Genomic DNA was extracted from blood samples and amplified by polymerase chain reaction (PCR). PCR primers flanked the polymorphic region in intro 16 of the ACE gene. Results OSAS patients had significantly higher frequencies of I/I genotype and insertion allele of the ACE gene as compared with the control subjects in Chinese population. The OSAS patients with I/I genotype had significantly longer apnea time, lower minimum SaO2 and greater AHI than the OSAS patients with I/D genotype. Conclusion These results indicate that the I/I genotype and I allele are a risk factor for OSAS in Chinese.

Therapeutic effects of different drugs on obstructive sleep apnea/hypopnea syndrome in children

Background:This study aimed to compare the therapeutic effects of different drugs on obstructive sleep apnea/hypopnea syndrome (OSAHS) in children by using a network meta-analysis approach.Methods:PubMed,Embase and Cochrane Library were searched from the inception of each database to November 2015.Randomized controlled trials (RCTs) concerning the comparisons in the therapeutic effects of eight placebo-controlled drugs on OSAHS in children were included in this study.Network meta-analysis combined direct evidence and indirect evidence to evaluate the weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRA) of therapeutic effects of eight drugs on OSAHS in children.Results:A total of seven RCTs were finally incorporated into our network meta-analysis.Pairwise meta-analysis results revealed that therapeutic effect of placebo was significantly poorer than that of intranasal mometasone furoate,montelukast,budesonide and fiuticasone concerning apnea hypopnea index (AHI) value [WMD=1.40,95% confidence interval (CI)=1.17-1.63;WMD=2.80,95% CI=1.01-4.59;WMD=3.50,95% CI=3.34-3.66;WMD=7.20,95% CI=5.26-9.14,respectively],and fluticasone is better than placebo concerning sleep efficiency (WMD=3.50,95% CI=2.42-4.58);regarding visual analogue scale,the therapeutic effect of placebo was poorer compared with sucralfate and clindamycin (WMD=1.94,95% CI=1.13-2.75;WMD=I.06,95%CI=0.22-1.90),and sucralfate is better than clindamycin (WMD=-0.88,95% CI=-1.65 to-0.11).However,network meta-analysis results showed no obvious difference in the therapeutic effects of different drugs on OSAHS regarding AHI and sleep efficiency.Furthermore,the best SUCRA value was very high for fluticasone concerning AHI (86.6%) and budesonide concerning sleep efficiency (94.0%) for OSAHS treatment.Conclusion:Fluticasone and budesonide have relatively good effects in the treatment of OSAHS in children,thus providing an important guiding significance for the treatment of OSAHS in children.

Prevalence and incidence of hypertension in obstructive sleep apnea patients and the relationship between obstructive sleep apnea and its confounders

Based on available population-based studies, Obstructive Sleep Apnea （OSA） associated with accompanying daytime sleepiness affects 3% to 7% of adult men and 2% to 5% of adult women in the general population. In some population subsets, like obese or older people, this prevalence is even higher. The health risk in OSA patients shows a strong association with acute cardiovascular events such as stroke, myocardial infarction and nocturnal sudden death. And with chronic conditions such as coronary artery disease,

Publication trends in obstructive sleep apnea: Evidence of need for more evidence

Objective:Published research in obstructive sleep apnea (OSA) appears limited despite OSA being a highly prevalent adult and pediatric disease leading to many adverse outcomes if left untreated.We aimed to quantify the deficit in OSA scientific literature in order to provide a novel way of identifying gaps in knowledge and a need for further research inquiry.Mlethods:This was a Bibliometric analysis study.Using Ovid Medline database we analyzed and compared research output (medical and surgical) between adult OSA and similarly prevalent chronic conditions (Type Ⅱ diabetes (T2DM),coronary artery disease (CAD) and osteoarthritis (OA)) from December 2016 up to fifty years prior.Linear graphs were utilized to trend collected data.Utilizing same strategy,we compared publication trends for pediatric OSA to asthma and gastroesophageal reflux (GER).Results:Adult OSA publications (n =9314) were significantly underrepresented when compared to T2DM (n =66,023),CAD (n =31,526) and OA (n =34,123).Linear plots demonstrated that despite increasing number of publications this disparity persisted annually.Surgical literature composed 10.4％ (n =972) of adult OSA publications and reached a plateau in the last ten years.Pediatric OSA (n =2994) had less research output when compared to asthma (n =47,442) and GER (n =6705).However,over past five years pediatric OSA surpassed GER in annual number of publications.Surgical literature represented 23.1％ (n =693) of pediatric OSA publications and continued increasing over past ten years.Study methodologies for both adult and pediatric OSA showed a lack of randomized controlled trials and meta-analyses in comparison to other diseases.Conclusion:Our review shows substantial deficit in total,annual and surgical adult OSA published research compared to similarly prevalent diseases.This trend is not entirely observed in pediatric OSA literature.

Updates on management of pediatric obstructive sleep apnea

Obstructive sleep apnea(OSA)affects about 1%-5%of the pediatric population.The consequences of untreated OSA in children include neurocognitive deficits,behavioral problems,poor school performance as well as systemic and pulmonary hypertension.The treatment options for pediatric OSA are numerous with a variety of surgical and non-surgical interventions.As our understanding of the complexities of OSA grows,the options for management have continued to expand as well.The objectives of this review are to describe the commonly prescribed treatments for pediatric OSA including adenotonsillectomy as well as use of positive airway pressure.We also highlight other surgical and non-surgical interventions available.In addition,we provide updates on current research focusing on newer diagnostic and experimental treatment modalities.

Airway Characteristics and Safe Management of Spontaneously Breathing Patients: Risks of Sedation and Analgesia and Changes in Wakefulness

The goal of safe airway management is to maintain a patent airway. Lack of knowledge of the anatomical morphology and changes that may occur in the upper airway during sedation and unconsciousness may lead to critical incidents and hazardous complications. This review focuses on the risks of sedation and analgesia and changes in wakefulness on airway patency in spontaneously breathing patients. Furthermore, key elements of airway management are presented and discussed.

阻塞性睡眠呼吸暂停综合征、肥胖、代谢综合征的病理生理联系及治疗进展

全球范围内超重和肥胖发生率持续上升,阻塞性睡眠呼吸暂停综合征(OSAS)的首要危险因素是肥胖,在全世界肥胖人口数量升高的同时,OSAS患病率也不断上调。OSAS与肥胖密切相关,肥胖通过促进气道的可塌陷性等原因导致OSAS,OSAS通过睡眠减少、食欲亢进等机制加重肥胖。肥胖极易引发代谢综合征(MS),OSAS对于MS具有促发效应,逆转肥胖可能是打破这一恶性循环的关键。对于OSAS,主要的传统疗法为无创呼吸机持续正压通气治疗,此疗法虽然可使OSAS患者睡眠时的缺氧问题及呼吸暂停症状得到改善,但并不能改善患者的代谢状态。目前,对于OSAS治疗的最新进展包括运动、饮食控制等生活方式的干预,使用一些新上市的减肥药物及中药和中医点穴,同时使用设计的唱歌训练法等方式,以及目前仍处于研究阶段的棕色脂肪、基因靶向治疗等,这些新进展的发现可能是改善OSAS合并MS及肥胖患者预后的有效手段。

OSA儿童错[牙合]畸形矫治临床路径

儿童阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)是睡眠呼吸障碍中最严重的类型,可导致牙颌面错牙合畸形,而后者又可造成儿童OSA的发生与发展。OSA儿童错牙合畸形的治疗需要多学科合作,建议正畸医师在接诊儿童患者时密切关注患儿的睡眠呼吸状况,对伴有OSA的错牙合畸形患儿,应综合考量患儿的年龄、生长发育阶段、OSA严重程度及错牙合畸形表现,制定个性化的治疗方案,为患儿牙颌面乃至全身的健康发育创造有利条件。

阻塞性睡眠呼吸暂停患儿家属对张口呼吸认识状况的质性研究

目的:了解阻塞性睡眠呼吸暂停(OSA)患儿家属对患儿张口呼吸认识状况,为实施有效的干预措施提供科学依据。方法:采用质性研究中的现象学研究方法,对符合标准的15名研究对象进行半结构、面对面访谈,采用Colaizzi七步分析法对访谈资料进行分析、提炼主题。结果:共获得5个主题,分别是感知到儿童OSA对患儿的不良影响、缺乏正规途径了解张口呼吸相关知识、缺乏正确判断患儿是否存在张口呼吸的方法、处理张口呼吸的方式不正确、患儿家属对手术治疗结果期待过高。结论:OSA患儿家属能积极通过各种途径了解儿童OSA的危害,但对于张口呼吸的危害认识不足,缺乏正规了解张口呼吸相关知识途径,且缺乏简易的检测口鼻气流的方法,有些家属在发现患儿张口呼吸后也并没有采取正确的干预措施。护理人员可通过指导患儿家属进行简易判断张口呼吸的方法,促使家属及早发现张口呼吸,进行干预治疗,术后也可更准确观察术后效果,积极控制相关危险因素,从而更好地避免颌面部畸形等并发症的发生,达到患儿及家属预期的治疗效果。

儿童口呼吸的多学科诊疗原则

儿童口呼吸不仅影响儿童的牙颌面生长发育,还可能因合并阻塞性睡眠呼吸暂停而严重影响患儿的身心健康。口呼吸包括阻塞性口呼吸和习惯性口呼吸,其发生发展可能与炎症、免疫、遗传、发育异常等相关,也可能累及牙颌面发育、牙齿排列及咬合关系、颞下颌关节、口周肌群功能、上气道大小等。因此,儿童口呼吸的治疗不仅仅是单纯改变呼吸习惯,而应该是多学科联合针对不同器官/系统的病因而制定序列的治疗方案。本文从口腔正畸医生为主的角度,分析不同类型口呼吸的危害和诊疗流程,为临床医生治疗该疾病提供参考。

阻塞性睡眠呼吸暂停综合征对肥胖病人肺功能的影响分析

目的探讨阻塞性睡眠呼吸暂停综合征(obtructive sleep apnea,OSAHS)对肥胖病人肺功能的影响。方法选取2018年9月至2022年4月徐州医科大学附属医院睡眠中心就诊的160例肥胖病人,行多导睡眠监测(polysomnography,PSG)、肺功能检查及血液相关化验,依据呼吸暂停低通气指数(apnea hypopnea index,AHI)分为四组:单纯肥胖组(33例)、肥胖合并轻度OSAHS组(31例)、肥胖合并中度OSAHS组(32例)、肥胖合并重度OSAHS组(64例),分析年龄、身体质量指数(BMI)、Epworth嗜睡量表(epworthsleepiness scale,ESS)、AHI、平均血氧饱和度(MSaO_(2))、最低血氧饱和度(LSaO_(2))、最长呼吸暂停时间(LAT)、各项肺功能指标。结果与单纯肥胖组相比,肥胖合并重度OSAHS组肺总量(TLC)[(82.27±13.89)L比(91.30±8.94)L]、重度组肺活量、用力肺活量(FVC)、补呼气容积(ERV)显著减低(P<0.05)。校正BMI、年龄后,AHI与肺活量、FVC、TLC、功能残气量(FRC)呈负相关(P<0.05),AHI与一秒率(FEV_(1)/FVC)、每升肺泡容积的一氧化碳弥散量(Kco)呈正相关(P<0.05);MSaO_(2)与肺活量、FVC、TLC及第1秒用力呼气容积(FEV_(1))呈正相关(P<0.05);LSaO_(2)与肺活量、FVC、ERV、FEV_(1)、TLC、FRC呈正相关(P<0.05),LSaO_(2)与Kco呈负相关(P<0.05)。多因素逐步回归分析结果显示AHI对FVC具有显著影响(P<0.05),LSaO_(2)、MSaO_(2)对肺活量、TLC具有显著影响(P<0.05),LSaO_(2)、BMI对FEV_(1)具有显著影响(P<0.05),AHI、BMI对Kco具有显著影响(P<0.05)。结论对于患有OSAHS的肥胖病人,尤其是严重OSAHS病人,其多项肺功能指标明显下降;AHI是肥胖病人肺功能指标FVC的独立危险因子,LSaO_(2)是肥胖病人肺活量、TLC、FEV_(1)损害的独立危险因子。AHI和LSaO_(2)可能成为肥胖合并OSAHS病人肺功能损害的预测因子,肺功能检查可以作为肥胖病人OSAHS严重程度的辅助评估手段。

肺气肿对阻塞性睡眠呼吸暂停综合征患者睡眠呼吸监测指标的影响

目的:探讨合并肺气肿对阻塞性睡眠呼吸暂停综合征(OSAS)患者睡眠呼吸监测指标的影响。方法:选取2022年4月至2023年9月三明市第一医院收治的OSAS患者72例作为研究对象,按照是否合并肺气肿分为对照组和观察组,对照组为单纯OSAS患者不合并肺气肿(n=41),观察组合并肺气肿(n=31),采用多导睡眠呼吸监测器监测2组患者的睡眠呼吸情况,并比较睡眠呼吸监测指标,比较2组患者的肺功能指标水平,比较2组患者睡眠状态下的血氧相关指标,比较2组患者睡眠质量。结果:观察组患者的睡眠监测指标均显著高于对照组,差异有统计学意义(P<0.05),观察组患者的FEV_(1)%、FEV_(1)/FVC以及TV均显著低于对照组,差异有统计学意义(P<0.05),观察组患者的血氧饱和度均显著高于对照组,差异有统计学意义(P<0.05),观察组最低80%以下氧饱和度次数和最低80%以下氧饱和度时间均显著低于对照组,差异有统计学意义(P<0.05),观察组患者的PSQI评分显著低于对照组,差异有统计学意义(P<0.05)。结论:合并肺气肿对OSAS患者的睡眠呼吸监测指标、肺功能指标以及血氧含量均会产生不良影响,临床上可针对合并疾病的患者及时作出治疗方案。