摘要
目的通过Siddiqui及Haba-Rubio两个方法定义阻塞性睡眠呼吸暂停低通气综合征(OSAHS)快动眼(REM)与非快动眼(NREM)分型,分析两型的整晚多导睡眠监测(PSG),探讨两个定义的合理性以及睡眠分期评估OSAHS病情价值。方法分别采用Siddiqui及Haba-Rubio方法,根据不同睡眠期的呼吸暂停低通气指数(AHI)将99例成年男性患者分为REM1型、NREM1型及REM2型、NREM2型,比较两个方法下的两型结果差异以及两型间总体及各程度分组中PSG参数的差异。结果Siddiqui方法定义的REM1型患者61例(52.6%)、NREM1型患者38例(38.4%),两型在年龄、体重指数(BMI)、睡眠结构、最低血氧饱和度(LSaO2)、OSAHS严重程度上均无统计学意义(P均>0.5)。Haba-Rubio方法定义的REM2型患者13例(13.1%)、NREM2型患者86例(86.9%),两型在年龄、睡眠结构、REM期AHI、LSaO2、REM期的差异均无统计学意义(P>0.05),REM2型的BMI、AHI、NREM-AHI比NREM2型低,而LSaO2、REM期LSaO2、NREM期LSaO2比NREM2型高(t值分别为2.916、-6.177,Z值分别为-4.372、-3.603、-3.552、-3.582,P均<0.05)。OSAHS轻、中、重组REM2型构成比分别为30.0%、67.9%、1.6%;NREM2型构成比分别为70.0%、32.1%、98.4%(P<0.001)。结论Haba-Rubio方法的分型比Siddiqui方法更合理,REM型主要分布于轻、中度OSAHS,NREM型则集中在重度OSAHS,呼吸暂停及低通气事情可能始发于REM期。
Objective To investigate the rationality and effectiveness of the two types in the evaluation of OSAHS via Siddiqui and Haba-Rubio methods to define the types of Rapid Eye Movement (REM) and Non-Rapid Eye Movement (NREM) of obstructive sleep Apnea-hypopnea syndrome (OSAHS) under PSG.Methods 99 adult males were respectively divided into the REM1 group,the NREM1 group,the REM2 group and the NREM2 group according to Siddiqui and Haba-Rubio methods,and the data of the two different results and PSG parameter differences in different groups were compared and discussed. Results It defined 61 patients as the REM1 group (52.6%) and 38 patients as the NREM1 group (38.4%) via Siddiqui method.The two groups had no statistical difference in age,body mass index (BMI),sleep structure,lowest arterial oxygen saturation (LSaO 2),and severity of OSAHS ( P> 0.5).It defined 13 patients as the REM2 group (13.1%) and 86 patients as the NREM2 group (86.9%) via Haba-Rubio method.The two groups had no statistical difference in age,sleep structure,AHI in REM stage,LSaO 2 in REM stage ( P> 0.05).BMI,AHI and NREM-AHI of the REM2 group were lower than those of the NREM2 group,while LSaO 2 and LSaO 2 in REM stage and LSaO 2 in NREM stage of the REM2 group were higher than those of the NREM2 group (t=2.916 and -6.177;Z=-4.372,-3.603,-3.552,and -3.582,P< 0.05).REM2 composition ratio in the light,middle and heavy groups of OSAS was 30.0%,67.9% and 1.6%,respectively,and NREM2 composition ratio was 70.0%,32.1% and 98.4%,respectively ( P< 0.001).Conclusion Haba-Rubio method can be more reasonable than Siddiqui method in evaluating the effectiveness of the treatment of OSAHS disease.REM is mainly distributed in light and middle OSAHS,while NREM is concentrated on heavy OSAHS.Apnea and hypopnea may begin from REM stage.
作者
莫建明
唐安珏
徐平
宋卫东
MO Jian-ming;TANG An-jue;XU Ping;SONG Wei-dong(Department of Respiration,Peking University Shenzhen Hospital,Shenzhen,Guangdong 518000,China)
出处
《临床肺科杂志》
2019年第8期1389-1393,共5页
Journal of Clinical Pulmonary Medicine
基金
2018年度深圳市卫生系统科研项目(No SZBC2018019)
