摘要
目的 探讨无眼部症状的阻塞性睡眠呼吸暂停综合征(OSAS)患者图形视觉诱发电位(PVEP)的变化及其相关因素.方法 纳入2015年3-10月中国医科大学附属第一医院睡眠室确诊的OSAS患者83例,其中男70例,女13例,年龄21 ～71岁,平均(44±12)岁,同期体检中心的健康对照者18名,其中男11名,女7名,年龄20～60岁,平均(40±13)岁,均于行多导睡眠监测前进行PVEP检查,比较各组间P100波潜伏期时间(LP100)和P100波振幅(AP100)的差别,对OSAS组PVEP结果与睡眠监测指标进行相关分析,探讨引起PVEP变化的相关因素.结果 83例患者轻度11例,中度17例,重度55例,与对照组[97(95～100) ms,9(8～ 10) μV]比较,轻、中、重度OSAS患者LP100均显著延长,其中轻度OSAS组为101 (98 ～ 103) ms,中度OSAS组为101 (98～105) ms,重度OSAS组为105(101～108)ms(均P＜0.05);而AP100显著降低,其中轻度OSAS组为7(5 ～8) μV,中度OSAS组为6(5 ～7) μV,重度OSAS组为6(4～7) μV(均P＜0.05),其中重度OSAS组LP100明显长于轻、中度OSAS组(P＜0.05).相关分析结果表明,OSAS患者的LP100与氧减指数、血氧饱和度＜90％占整个睡眠时间的百分比(Tg0)、呼吸暂停低通气指数(AHI)、夜间最低氧饱和度(LSaO2)及夜间平均氧饱和度(MSaO2)均相关,逐步多元线性回归发现LP100只与AHI正相关(r=0.275,P＜0.01).结论 在出现相关眼部疾病临床表现前,OSAS患者已出现PVEP异常,其异常程度与病情严重度密切相关.
Objective To objectively evaluate visual function by pattern visual evoked potential (PVEP) and its related factors in patients with obstructive sleep apnea syndrome (OSAS)without any ocular symptoms.Methods Eighty-three newly diagnosed OSAS and 18 normal subjects were enrolled in the study.The OSAS patients were divided into mild (n =11),moderate(n =17) and severe (n =55) groups based on the apnea-hypopnea index (AHI).Before the polysomnography (PSG) test,all participants underwent a PVEP examination measuring the latency and amplitude of P100.Results Compared to healthy controls,the latency of P100 was significantly increased in OSAS patients [controls group:97 (95-100) ms,mild OSAS group:101 (98-103) ms,moderate OSAS group:101 (98-105) ms,severe OSAS group:105 (101-108) ms,all P ＜ 0.05],and the amplitude of P100 was significantly reduced [controls group:9 (8-10) μV,mild OSAS group:7(5-8) μV,moderate OSAS group:6(5-7) μV,severe OSAS group:6 (4-7) μV,all P ＜0.05].The severe group showed significantly longer latency of P100 when compared with mild and moderate groups (P ＜ 0.05).In the OSAS patients,univariate analysis showed that,the latency of P100 was correlated with ODI,T90,AHI,sleep efficiency,minimum SaO2,and mean SaO2,and the amplitude of P100 was statistically associated with sleep efficiency.But the stepwise multiple linear regression analysis revealed that only AHI was significantly correlated with the latency of P100 (r =0.275,P ＜ 0.01).Conclusion Abnormal PVEP was found in patients with OSAS without any clinical manifestations of the optic neuropathy.The dysfunction of optic nerve was significantly associated with AHI and sleep efficiency.
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2016年第9期709-713,共5页
Chinese Journal of Tuberculosis and Respiratory Diseases
基金
辽宁省高等学校创新团队支持计划，辽宁省特聘教授项目(辽教[2011]55号)Supported by Program for Liaoning Innovative Research Team in University，Project of Distinguished Professor of Liaoning Province
