摘要
目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSASH)患者睡眠呼吸暂停低通气指数(AHI)分级的情况及其影响因素。方法选取2019年7月至2021年7月喀什地区第一人民医院收治的300例睡眠呼吸障碍患者作为研究对象。按照AHI进行分组,AHI<5次/h且多导睡眠监测(PSG)提示有鼾声分为单纯鼾症组;5~14次/h为轻度,15~30次/h为中度,>30次/h为重度,均分为OSASH组。采用单因素分析筛选影响OSASH患者的有关因素,采用多因素logistic回归分析AHI分级的独立危险因素;采用因子分析法对所有因素进行降维分析,并对各因子进行旋转,抽取公因子。结果300例OSAHS患者中,单纯鼾症组168例(56.00%)、OSASH组132例(44.00%),其中轻度74例(56.06%)、中度23例(17.42%)、重度35例(26.52%)。单纯鼾症组和OSASH组患者的体重指数(BMI)、高血压史、糖尿病史、颈围、腹围、收缩压、舒张压、Epworth嗜睡量表(ESS)、AHI、呼吸暂停或低通气次数、呼吸暂停或低通气累计时间比较,差异有统计学意义(P<0.05)。不同程度的OSAHS患者BMI、ESS、AHI、呼吸暂停或低通气次数、呼吸暂停或低通气累计时间、血氧饱和度比较,差异有统计学意义(P<0.05);抽取公因子方差特征值≥1的独立因子共4个,即PSG监测相关指标、心血管相关指标、年龄病史情况、民族体质指标。多因素logistic的分析结果显示,BMI、ESS、AHI、呼吸暂停或低通气次数、呼吸暂停或低通气累计时间为OSAHS发病程度的危险因素(OR>1,P<0.05)。结论BMI、ESS、AHI、呼吸暂停或低通气次数、呼吸暂停或低通气累计时间是OSASH患者严重程度的独立影响因素,临床应针对这些因素予以干预。
Objective To investigate the sleep apnea hypopnea index(AHI)grade in patients with obstructive sleep apnea hypopnea syndrome(OSASH)and its independent risk factors.Methods A total of 300 patients with sleep-disordered breathing admitted to the First People′s Hospital of Kashgar from July 2019 to July 2021 were selected as the research objects.According to AHI,AHI<5 times/h and polysomnography(PSG)indicated snoring were divided into simple snoring group.5-14 times/h was considered as mild,15-30 times/h was considered as moderate,and>30 times/h was considered as severe.All patients were divided into OSASH group.Univariate analysis was used to screen the related factors of OSASH patients,and multivariate logistic regression was used to analyze the independent risk factors of AHI classification.The factor analysis method was used to reduce the dimension of all factors,and the factors were rotated to extract the common factors.Results Among the 300 OSAHS patients,168 were simple snoring(56.00%)and 132 were in the OSASH group(44.00%),of which 74 were mild(56.06%),23 were moderate(17.42%),and 35 were severe(26.52%).There were significant differences in body mass index(BMI),history of hypertension,history of diabetes,neck circumference,abdominal circumference,systolic blood pressure,diastolic blood pressure,Epworth sleeping scale(ESS),AHI,frequency of apnea or hypopnea,and cumulative time of apnea or hypopnea between simple snoring group and OSASH group(P<0.05).There were statistically significant differences in BMI,ESS,AHI,times of apnea or hypopnea,cumulative time of apnea or hypopnea,and blood oxygen saturation in patients with different degrees of OSAHS (P<0.05). A total of 4 independent factors with common factor variance eigenvalue ≥1 were extracted, namely PSG monitoring related indicators, cardiovascular related indicators, age and medical history, and ethnic body mass indicators. Multivariate logistic analysis showed that BMI, ESS, AHI, times of apnea or hypopnea, and cumulative time of apnea or hypopnea were risk factors for the severity of OSAHS (OR>1, P<0.05). Conclusion BMI, ESS, AHI, the number of apnea or hypopnea, and the cumulative time of apnea or hypopnea are independent influencing factors of the severity of OSASH patients. Clinical interventions should be targeted at these factors.
作者
郑爱芳
王梁
李黎
ZHENG Aifang;WANG Liang;LI Li(Department of Respiratory and Critical Care,the First People′s Hospital of Kashgar,Xinjiang Uygur Autonomous Region,Kashgar 844000,China)
出处
《中国当代医药》
CAS
2022年第27期5-9,共5页
China Modern Medicine
基金
新疆维吾尔自治区喀什地区应用技术研究与开发计划项目(KS2019020)。
关键词
阻塞性睡眠呼吸暂停低通气综合征
多因素回归分析
因子分析
模型预测
Obstructive sleep apnea hypopnea syndrome
Logistic multivariate regression analysis
Factor analysis
Model prediction
