摘要
目的 :根据阻塞性睡眠呼吸暂停综合征 (obstructivesleepapneasyndrom ,OSAS)患者多导睡眠仪(polysomnography ,PSG)监测信号 ,研究OSAS患者快速眼动睡眠损伤的特点。方法 :( 1)使用呼吸事件新分型法对 33例OSAS患者及正常打鼾者PSG监测信号进行分型 ,根据Ⅱ、Ⅲ型曲线的发生率将 33例OSAS患者分为轻度 ,中度和重度阻塞性呼吸暂停 3组 ;( 2 )比较 3组患者REM期睡眠时间长度 ;REM期呼吸紊乱特点。结果 :( 1) 3组患者REM期睡眠时间分别为 37.9± 11.3min ;12 .8± 3.1min ;7.3± 3.6min ,轻度组患者REM期睡眠时间较长 ,重度组患者REM期睡眠时间短 ,且易消失 ;( 2 )轻度组患者REM期RDI、RIT及SIT90 指数均较NREM期加重 ;重度组患者REM期RDI指数较NREM期显著减少 ,但RIT及SIT90 指数REM和NREM差异无显著性。结论 :( 1)根据新分型进行病情轻重分类能够反映患者REM期的损害程度 ,病情较重的患者REM期减少甚至消失 ;( 2 )轻度组患者REM期病情较NREM期加重 ,表现为RDI、RIT及SIT90 指数均显著增加 ;重度组患REM期较NREM期RDI减少 ,但呼吸及血氧损害程度无显著变化 。
Objictive:To study the characteristics of the respiratory disturbance during REM sleep in OSAS through the signals surveyed by PSG.Methods:A. 33 cases of OSAS patients were classified the respiratory events with the new method,and they were divided into mild,moderate and severe OSAS according to the frequency of the type Ⅱ and type Ⅲ curves.B.The course and the respiratory disturbance characteristics in REM period were compared in the 3 groups.Results:A.The duration of the stage REM was 37.9±11.3min;12.8±3.1min and 7.3±3.6min respectively in the 3 groups.The duration of the stage REM was longer in mild group than that in severe group.B.In mild group,the RDI,RIT and SIT 90 were all higher in REM period than those in NREM period.In severe group,the RDI was lower in REM period than that in NREM period,but the RIT AND SIT 90 had no significant difference in the 2 periods.Conclusion:A.The respiratory disturbance degree in REM period can be revealed through the patients condition proved by the new classification.The REM stage is deduced or disappera in severe patient.B.In mild OSAS,the magnificant increasing of RDI,RIT and SIT 90 expressthat the condition in REM period is worse than that is NREM period.In severe OSAS,the mean duration of respiratory events in REM period is prolonged,so the RDI is decreased with no significant difference of the impairment to the respiratory and SaO 2 between the REM and NREM period.
关键词
睡眠呼吸暂停综合征
睡眠
快速眼动
Sleep apnea syndromes
Sleep
stages
Sleep
REM
Polysomonography
