不同觉醒阈值阻塞性睡眠呼吸暂停低通气患者对血气、糖脂代谢水平的影响

doi:10.6040/j.issn.1673-3770.0.2023.170

摘要/Abstract

摘要： 目的探讨不同觉醒阈值阻塞性睡眠呼吸暂停低通气(obstructive sleep apnea hypopnea syndrome, OSAHS)患者疾病特征及临床指标的变化,并分析觉醒阈值与特定临床因素的相关性。方法连续性选取2018年9月至2022年6月经多导睡眠监测(polysomnography, PSG)诊断为OSAHS的成年男性患者,最终纳入107例。根据觉醒阈值评分进行分组,收集所有患者动脉血气及生化指标,比较高觉醒阈值OSAHS组与低觉醒阈值OSAHS组的PSG参数及动脉血气、生化指标,进一步对呼吸暂停低通气指数(apnea hypopnea index, AHI)进行校正,使用线性回归方法分析不同觉醒阈值对差异显著的生化指标的影响。同时分析觉醒阈值评分和特定临床指标的相关性。结果高觉醒阈值组AHI、呼吸暂停指数(apnea index, AI)、呼吸暂停最长时间(longest apnea time, LAT)、呼吸暂停平均时间(mean apnea time, MAT)、氧减指数(oxygen desaturation index, ODI)、血氧饱和度低于90%占总睡眠时间的百分比、总胆固醇(total cholesterol, TC)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin, LDL-C)均高于低觉醒阈值组;低觉醒阈值组睡眠最低氧饱和度(lowest oxygen saturation, LSaO₂)及睡眠平均氧饱和度(mean oxygen saturation, MSaO₂)均高于高觉醒阈值组,而在校正AHI后,线性回归分析结果显示TC及LDL-C均与觉醒阈值无关。相关性分析显示觉醒阈值评分与AHI、AI、LAT及MAT呈负相关,与LSaO₂及MSaO₂呈正相关。结论不同觉醒阈值OSAHS患者存在脂代谢改变,可能是OSAHS患者代谢紊乱的潜在生物标志物。

关键词: 阻塞性睡眠呼吸暂停低通气综合征, 觉醒阈值, 动脉血气指标, 脂代谢紊乱

Abstract: Objective This study aimed to investigate variations in clinical characteristics among patients with obstructive sleep apnea hypopnea syndrome(OSAHS)who exhibit different arousal thresholds and to analyze the correlation between arousal thresholds and clinical factors. Methods We selected 107 adult male patients diagnosed with OSAHS by polysomnography(PSG)from September 2018 to June 2022. The patients were categorized based on their arousal threshold scores and underwent arterial blood gas and biochemical examinations. We compared the PSG parameters, arterial blood gas, dyslipidemia, and fasting plasma glucose. Linear regression was used to estimate the association between significant variables and arousal threshold after adjusting for apnea hypopnea index(AHI). Additionally, we analyzed the correlation between arousal threshold and specific clinical factors. Results The high arousal threshold group had higher AHI, apnea index(AI), longest apnea time(LAT)and mean apnea time(MAT), oxygen desaturation index(ODI), percentage of total sleep time with oxygen saturation below 90%, total cholesterol(TC), and low-density lipoprotein cholesterol(LDL-C)compared to the low arousal threshold group. Conversely, the low arousal threshold group had higher values for the lowest oxygen saturation(LSaO₂)and mean oxygen saturation(MSaO₂)during sleep compared to the high arousal threshold group. However, both TC and LDL-C showed no correlation with arousal threshold after adjusting for AHI. Furthermore, the arousal threshold score was negatively correlated with AHI, AI, LAT and MAT, and positively correlated with LSaO₂ and MSaO₂. Conclusion Patients with OSAHS who had different arousal threshold showed changes in lipid metabolism, which may be potential biomarkers of metabolic disorders in such patients.

Key words: Obstructive sleep apnea hypopnea syndrome, Arousal threshold, Arterial blood gas, Dyslipidemia

中图分类号:

R766

邢亮,袁钰淇,谢雨杉,苏永龙,牛晓欣,麻莉娜,王子桐,刘海琴,施叶雯,任晓勇. 不同觉醒阈值阻塞性睡眠呼吸暂停低通气患者对血气、糖脂代谢水平的影响[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 106-111.

XING Liang, YUAN Yuqi, XIE Yushan, SU Yonglong, NIU Xiaoxin, MA Lina, WANG Zitong, LIU Haiqin, SHI Yewen, REN Xiaoyong. Metabolic markers in obstruetive sleep apnea hypopnea syndrome patients with different arousal thresholds[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 106-111.

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