快速动眼睡眠相关性阻塞性睡眠呼吸暂停事件的临床研究

蒋康伦; 赵琳; 李姝娜; 林志强; 马永明; Iqbal M A; 钱炜

doi:10.13201/j.issn.1001-1781.2017.10.002

快速动眼睡眠相关性阻塞性睡眠呼吸暂停事件的临床研究

- 江苏大学附属人民医院耳鼻咽喉头颈外科(江苏镇江, 212002)
基金项目:
江苏省六大人才高峰项目(No:2011-WSN021D)

江苏省医学科研招标立项课题(No:H201353)

镇江市科技支撑社会发展项目(No:SH2012042,SH2014045)

详细信息

通讯作者: 钱炜,E-mail:dwqian@yahoo.com

中图分类号: R762

收稿日期: 2016-12-08

A preliminary clinical classification study in REM related obstructive sleep apnea

- Department of Otolaryngology Head and Neck Surgery, Jiangsu University Affiliated People's Hospital, Zhenjiang, 212002, China

More Information

Corresponding author: QIAN Wei, E-mail: dwqian@yahoo.com

Received Date: 08 December 2016

摘要

摘要: 目的: 探讨一种基于快速动眼睡眠期(REM)相关的阻塞性睡眠呼吸暂停事件(OSA)发生特征的分型方法及潜在临床意义。方法: 250例OSA患者根据PSG分型:REM期相关组[RrOSA,REM期AHI与非REM期AHI(NREM-AHI)比值(R)>1,113例],非REM期相关组(NRrOSA,R≤1,137例);RrOSA组进一步分为RrOSA Ⅰ型(R≥2,34例)与RrOSA Ⅱ型(R>1,79例)。RrOSA Ⅰ型再根据非REM期AHI分为2个亚型:RrOAS Ⅰa型(NREM_AHI <15,24例)与RrOSA Ⅰb型(NREM_AHI≥15,10例)。比较各分组PSG与临床数据。结果: RrOSA组患者AHI、ODI、NREM_AHI、NREM_ODI、REM期最大氧减、REM期最长氧减时间、NREM期最长氧减时间均显著低于NRrOSA组患者(均P<0.01)。REM期AHI或ODI 2组间无差异(P>0.05)。RrOSA各亚组之间REM期(AHI、ODI、最大氧减、最长氧减时间)、NREM期(AHI、ODI、最大氧减、最长氧减时间)均存在逐渐升高趋势。部分RrOSA Ⅰa组患者不耐受CPAP治疗,改用APAP治疗后效果满意。结论: 对RrOSA进行进一步分组分析不同分期睡眠参数改变有助于了解OSA病程发生、发展。RrOSA Ⅰa分组对CPAP治疗模式选择可能存在指导意义。RrOSA可能是OSA患者中的一种特殊类型,这种类型可能随着病情严重而发展为其他类型。
- 阻塞性睡眠呼吸暂停综合征 /
- 快速动眼睡眠 /
- 正压通气治疗
Abstract: Objective: The aim of this study is to introduce a method in classifying the REM related OSA(RrOSA) and the potential clinical significance.Method: Two hundred and fifty patients(male: 219) with OSAS diagnosed by polysomnographywere recruited in the study. The RrOSAS was defined as the ratio of AHIs in REM and non REM sleep(R) greater than one. In RrOSAS group, patients were divided into RrOSAS Ⅰa(R>2, NREM_AHI<15),RrOSAS Ⅰb(R>2, NREM_AHI>15), and RrOSAS II (2>R>1) three subtypes. Parameters of PSG, ESS, BMI and neck circufernces were obtained for further analysis. In RrOSA Ⅰa group, the efficiencies of CPAP and AutoPAP were investigated.Result: ①There was a significant difference in gender between RrOSA and NRrOSA groups(P<0.05);②There was no significant differences in ESS and BMI among the three subtypes of RrOSA(P>0.05); ③There was no significant difference in REM_AHI and REM_ODI between RrOSA and NRrOSA groups.Conclusion: The new method for the RrOSA classification helps better understanding the development of OSAS and might be useful in planning the CPAP treatment. RrOSA may be a special type of OSA, which may develop into other types as the condition develops.
- OSA /
- REM sleep /
- CPAP

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