目的评价鼻腔扩容术治疗OSAHS患者主客观症状的改善情况。方法观察30例行鼻腔扩容术的成年OSAHS患者,所有患者于术前进行多道睡眠图(PSG)描记,鼻声反射和鼻阻力测试等鼻功能检查,填写白天嗜睡主观评分Epworth嗜睡量表(Epworth sleepines...目的评价鼻腔扩容术治疗OSAHS患者主客观症状的改善情况。方法观察30例行鼻腔扩容术的成年OSAHS患者,所有患者于术前进行多道睡眠图(PSG)描记,鼻声反射和鼻阻力测试等鼻功能检查,填写白天嗜睡主观评分Epworth嗜睡量表(Epworth sleepiness score,ESS)、鼻塞主观视觉模拟量表(visual analogue scale,VAS)评分、鼾声评分量表,以上主客观检查于鼻腔手术后3个月重复记录。所有患者接受鼻腔扩容术(鼻中隔三线减张成形术、双侧下鼻甲外移、双侧中鼻甲内移和双侧中鼻道鼻窦对称性开放)。结果鼻腔扩容术后患者鼻腔总阻力显著降低[(0.89±0.23)kPa·s/L vs(0.29±0.12)kPa·s/L,P<0.01],鼻塞VAS评分显著降低[8.2±1.1 vs 2.1±0.73,P<0.01],白天嗜睡ESS评分显著降低(12.7±1.2 vs 8.6±2.9,P<0.01),打鼾程度减轻(62.2±25.6 vs 45.6±18.6,P<0.01)。轻度OSAHS患者呼吸暂停低通气指数(apnea and hypopnea index,AHI)较术前显著下降(P<0.05),觉醒指数较术前显著下降(P<0.01),最低动脉血氧饱和度(lowest SaO2,LSaO2)较术前显著升高(P<0.01)。中度和重度OSAHS患者的AHI指数、觉醒指数、LSaO2均较术前无显著改变(P>0.05)。LSaO2、睡眠结构各阶段的比例、快动眼睡眠阶段的长度在所有OSAHS患者均没有显著变化(P>0.05)。30例OSAHS患者鼻腔扩容术的总体有效率为26.7%。结论鼻腔扩容手术可以改善OSAHS患者鼻塞及白天嗜睡、睡眠打鼾等相关睡眠主观症状,并在一定程度上改善OSAHS患者的阻塞性睡眠呼吸暂停的严重程度,应适当选择其手术适应证。展开更多
Background The nocturnal nondipping and elevated morning blood pressure （BP） in patients with obstructive sleep apnea syndrome （OSAS） have not yet been well investigated in Chinese patients. This study aimed to de...Background The nocturnal nondipping and elevated morning blood pressure （BP） in patients with obstructive sleep apnea syndrome （OSAS） have not yet been well investigated in Chinese patients. This study aimed to describe the BP profile, and to elucidate the relationships between daytime BP and nighttime BP, and between evening BP and morning BP in patients with OSAS. Methods Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006. BP assessments were made at four time points （daytime, evening, nighttime and morning） and polysomnography （PSG） was performed and subjects were classified into four groups by their apnea-hypopnea index （AHI）： control, n=213 with AHI 〈5; mild, n=420 with AHI -〉5 and 〈15; moderate, n=460 with AHI -〉15 and 〈30; and severe, n=1204 with AHI -〉30. SPSS 11.5 software package was used for statistical analysis and figure drawing. Results All the average daytime, nighttime, evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation. The ratios of nighttime/daytime and morning/evening average BP were positively correlated with AHI. The ratio of nighttime/daytime systolic BP became a ＂reversed BP dipping＂ pattern until the classification reached severe, while the ratio of nighttime/daytime diastolic BP became reversed at moderate. Similarly, the ratio of morning/evening diastolic BP becomes reversed even at mild. Conclusions OSAS may result in higher BP levels at all four time points. The ratios of nighttime/daytime and morning/evening BP increase with increased AHI. The increasing of diastolic BP, which is inclined to rise more quickly, is not parallel with increasing systolic BP.展开更多
目的:探讨阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与认知功能、抑郁及焦虑的关系,并分析影响认知功能的因素。方法:纳入2022年1月至2023年6月,安徽医科大学第三附属医院滨湖院区行多导睡眠监测(polysomnography,PSG)的患者共...目的:探讨阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与认知功能、抑郁及焦虑的关系,并分析影响认知功能的因素。方法:纳入2022年1月至2023年6月,安徽医科大学第三附属医院滨湖院区行多导睡眠监测(polysomnography,PSG)的患者共102例,根据PSG结果分为无或轻度OSA组及中、重度OSA组,完善蒙特利尔认知评估量表(MoCA-Beijing)、Stroop色词试验(stroop Color and Word Tset,SCWT)、数字广度测验(digit Span Test,DST)、抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS),记录各量表的评分值,并分析差异性及相关性等。结果:中-重度OSA组的颈围、BMI、SCWT-A、B、C耗时数、SIE、SAS、SDS显著高于无-轻度OSA组,MoCA视空间与执行能力、记忆、语言、抽象、延迟回忆、定向及MoCA总分、最低血氧饱和度(LSaO_(2))、平均血氧饱和度、DST-b、DST-f得分显著低于无-轻度OSA组(P均<0.05)。颈围、AHI、SAS与MoCA评分相关(OR=1.401,95%CI:1.702~1.803;OR=1.028,95%CI:1.007~1.050;OR=1.070,95%CI:0.991~1.155,P均<0.05),AHI与SDS、SAS评分相关(OR=1.001,95%CI:0.979~.025,P=0.003)。结论:中-重度OSA患者常合并认知功能障碍及抑郁、焦虑相关情绪问题,与AHI、LSaO_(2)、平均血氧饱和度指标密切相关,OSA合并焦虑与认知功能障碍具有显著相关性。展开更多
文摘目的评价鼻腔扩容术治疗OSAHS患者主客观症状的改善情况。方法观察30例行鼻腔扩容术的成年OSAHS患者,所有患者于术前进行多道睡眠图(PSG)描记,鼻声反射和鼻阻力测试等鼻功能检查,填写白天嗜睡主观评分Epworth嗜睡量表(Epworth sleepiness score,ESS)、鼻塞主观视觉模拟量表(visual analogue scale,VAS)评分、鼾声评分量表,以上主客观检查于鼻腔手术后3个月重复记录。所有患者接受鼻腔扩容术(鼻中隔三线减张成形术、双侧下鼻甲外移、双侧中鼻甲内移和双侧中鼻道鼻窦对称性开放)。结果鼻腔扩容术后患者鼻腔总阻力显著降低[(0.89±0.23)kPa·s/L vs(0.29±0.12)kPa·s/L,P<0.01],鼻塞VAS评分显著降低[8.2±1.1 vs 2.1±0.73,P<0.01],白天嗜睡ESS评分显著降低(12.7±1.2 vs 8.6±2.9,P<0.01),打鼾程度减轻(62.2±25.6 vs 45.6±18.6,P<0.01)。轻度OSAHS患者呼吸暂停低通气指数(apnea and hypopnea index,AHI)较术前显著下降(P<0.05),觉醒指数较术前显著下降(P<0.01),最低动脉血氧饱和度(lowest SaO2,LSaO2)较术前显著升高(P<0.01)。中度和重度OSAHS患者的AHI指数、觉醒指数、LSaO2均较术前无显著改变(P>0.05)。LSaO2、睡眠结构各阶段的比例、快动眼睡眠阶段的长度在所有OSAHS患者均没有显著变化(P>0.05)。30例OSAHS患者鼻腔扩容术的总体有效率为26.7%。结论鼻腔扩容手术可以改善OSAHS患者鼻塞及白天嗜睡、睡眠打鼾等相关睡眠主观症状,并在一定程度上改善OSAHS患者的阻塞性睡眠呼吸暂停的严重程度,应适当选择其手术适应证。
基金This study was supported by the grants from the National Natural Science Foundation of China （No. 30800507, No. 30770934）. All the coauthors from different centers in the name list have made equal contributions to this article. There is no ordering difference. None of the authors has a financial relationship with a commercial entity that has an interest in the subject of this manuscript.
文摘Background The nocturnal nondipping and elevated morning blood pressure （BP） in patients with obstructive sleep apnea syndrome （OSAS） have not yet been well investigated in Chinese patients. This study aimed to describe the BP profile, and to elucidate the relationships between daytime BP and nighttime BP, and between evening BP and morning BP in patients with OSAS. Methods Twenty teaching hospital sleep centers in China were organized by the Chinese Medical Association to participate in this study and 2297 patients were recruited between January 2004 and April 2006. BP assessments were made at four time points （daytime, evening, nighttime and morning） and polysomnography （PSG） was performed and subjects were classified into four groups by their apnea-hypopnea index （AHI）： control, n=213 with AHI 〈5; mild, n=420 with AHI -〉5 and 〈15; moderate, n=460 with AHI -〉15 and 〈30; and severe, n=1204 with AHI -〉30. SPSS 11.5 software package was used for statistical analysis and figure drawing. Results All the average daytime, nighttime, evening and morning BPs were positively correlated with AHI and negatively correlated with nadir nocturnal oxygen saturation. The ratios of nighttime/daytime and morning/evening average BP were positively correlated with AHI. The ratio of nighttime/daytime systolic BP became a ＂reversed BP dipping＂ pattern until the classification reached severe, while the ratio of nighttime/daytime diastolic BP became reversed at moderate. Similarly, the ratio of morning/evening diastolic BP becomes reversed even at mild. Conclusions OSAS may result in higher BP levels at all four time points. The ratios of nighttime/daytime and morning/evening BP increase with increased AHI. The increasing of diastolic BP, which is inclined to rise more quickly, is not parallel with increasing systolic BP.
文摘目的:探讨阻塞性睡眠呼吸暂停(obstructive sleep apnea,OSA)与认知功能、抑郁及焦虑的关系,并分析影响认知功能的因素。方法:纳入2022年1月至2023年6月,安徽医科大学第三附属医院滨湖院区行多导睡眠监测(polysomnography,PSG)的患者共102例,根据PSG结果分为无或轻度OSA组及中、重度OSA组,完善蒙特利尔认知评估量表(MoCA-Beijing)、Stroop色词试验(stroop Color and Word Tset,SCWT)、数字广度测验(digit Span Test,DST)、抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS),记录各量表的评分值,并分析差异性及相关性等。结果:中-重度OSA组的颈围、BMI、SCWT-A、B、C耗时数、SIE、SAS、SDS显著高于无-轻度OSA组,MoCA视空间与执行能力、记忆、语言、抽象、延迟回忆、定向及MoCA总分、最低血氧饱和度(LSaO_(2))、平均血氧饱和度、DST-b、DST-f得分显著低于无-轻度OSA组(P均<0.05)。颈围、AHI、SAS与MoCA评分相关(OR=1.401,95%CI:1.702~1.803;OR=1.028,95%CI:1.007~1.050;OR=1.070,95%CI:0.991~1.155,P均<0.05),AHI与SDS、SAS评分相关(OR=1.001,95%CI:0.979~.025,P=0.003)。结论:中-重度OSA患者常合并认知功能障碍及抑郁、焦虑相关情绪问题,与AHI、LSaO_(2)、平均血氧饱和度指标密切相关,OSA合并焦虑与认知功能障碍具有显著相关性。
