肥胖对OSAHS患者日间嗜睡的影响(1)
【摘要】 目的：探讨肥胖与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者日间嗜睡关系及对OSAHS患者影响。方法：经多导睡眠图(PSG)及体重指数(BMI)测评，分为OSAHS伴肥胖组40例，OSAHS不伴肥胖组38例，单纯肥胖组42例，测定三组体重指数(BMI)、呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度、爱泼沃斯嗜睡量表(ESS)评分、血清瘦素(LEP)水平并进行对比，分析ESS评分与AHI及LEP水平相关性。结果：OSAHS伴肥胖组ESS评分、LEP水平均高于OSAHS不伴肥胖组及单纯肥胖组，差异均有统计学意义(P<0.05);OSAHS不伴肥胖组ESS评分高于单纯肥胖组，差异有统计学意义(P<0.05);OSAHS伴肥胖组ESS评分与LEP水平呈明显正相关性，差异有统计学意义(P<0.05)。结论：OSAHS伴肥胖患者日间嗜睡症状与肥胖有关，而日间嗜睡发病机制可能与LEP水平变化有关。
【关键词】 阻塞性睡眠呼吸暂停低通气综合征 肥胖 嗜睡 瘦素
[Abstract] Objective： To investigate the relationship between obesity and daytime sleepiness in patients with OSAHS and its effects on patients with OSAHS. Method： After polysomnography (PSG) and body mass index (BMI) evaluation， 40 cases in the OSAHS with obesity group， 38 cases in the OSAHS without obesity group， and 42 cases in the simple obesity group. Body mass indexes (BMI)， apnea hypopnea indexes (AHI)， nighttime minimum oxygen saturation， Epworth sleepiness scale (ESS) scores and serum leptin (LEP) levels were measured and compared among the three groups， and the correlation between ESS score and AHI and LEP levels was analyzed. Result： The ESS score and LEP level of the OSAHS with obesity group were higher than those of the OSAHS without obesity group and the simple obesity group， and the differences were statistically significant (P<0.05). The ESS score of the OSAHS without obesity group was higher than that of the simple obesity group， and the difference was statistically significant (P<0.05). There was a significant positive correlation between ESS score and LEP level in the OSAHS with obesity group， and the difference was statistically significant (P<0.05). Conclusion： The symptoms of daytime sleepiness in patients with OSAHS and obesity are related to obesity， and the pathogenesis of daytime sleepiness may be related to LEP level changes.
阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome，OSAHS)是以在睡眠过程中反复发生呼吸暂停、低通气及微觉醒为特征的疾病[1]。OSAHS是睡眠障碍中最常見疾病[2]。肥胖为OSAHS患者首要危险因素[3]。日间嗜睡是OSAHS患者常见的临床表现之一，16%～22%的OSAHS患者存在日间嗜睡[4]。研究显示，OSAHS患者日间嗜睡与夜间缺氧程度及AHI相关，且患者BMI与AHI呈正相关[5]。但目前关于肥胖与日间嗜睡的独立关系的研究不多，且机制不清。肥胖程度与血清中瘦素浓度变化密切相关[6]。本研究通过对比是否伴肥胖的OSAHS患者日间嗜睡情况及血清瘦素水平，进一步探讨肥胖与OSAHS患者日间嗜睡关系及可能影响机制。
1 资料与方法
1.1 一般资料
研究对象均来自杭州市萧山区第一人民医院门诊、住院或健康体检中心，研究时间为2017年9月-2019年7月。OSAHS诊断标准：夜间7 h睡眠中呼吸暂停及低通气反复发作>30次或AHI≥5次/h，且以阻塞性呼吸暂停为主[7]。中国单纯性肥胖诊断标准：超重为BMI 25～26 kg/m2，肥胖为BMI>26 kg/m2。排除标准：心血管疾病、脑部疾病、老年痴呆、智力障碍、未控制的糖尿病、恶性肿瘤、甲状腺疾病、维生素缺乏、慢性阻塞性肺疾病、间质性肺疾病等。经多导睡眠图(PSG)及体重指数(BMI)测评，分为OSAHS伴肥胖组40例，OSAHS不伴肥胖组38例，单纯肥胖组42例。研究经医院伦理委员会同意，患者均签订知情同意书。, 百拇医药(郑艳文 邬海燕 胡立红 姜贻乾)
【关键词】 阻塞性睡眠呼吸暂停低通气综合征 肥胖 嗜睡 瘦素
[Abstract] Objective： To investigate the relationship between obesity and daytime sleepiness in patients with OSAHS and its effects on patients with OSAHS. Method： After polysomnography (PSG) and body mass index (BMI) evaluation， 40 cases in the OSAHS with obesity group， 38 cases in the OSAHS without obesity group， and 42 cases in the simple obesity group. Body mass indexes (BMI)， apnea hypopnea indexes (AHI)， nighttime minimum oxygen saturation， Epworth sleepiness scale (ESS) scores and serum leptin (LEP) levels were measured and compared among the three groups， and the correlation between ESS score and AHI and LEP levels was analyzed. Result： The ESS score and LEP level of the OSAHS with obesity group were higher than those of the OSAHS without obesity group and the simple obesity group， and the differences were statistically significant (P<0.05). The ESS score of the OSAHS without obesity group was higher than that of the simple obesity group， and the difference was statistically significant (P<0.05). There was a significant positive correlation between ESS score and LEP level in the OSAHS with obesity group， and the difference was statistically significant (P<0.05). Conclusion： The symptoms of daytime sleepiness in patients with OSAHS and obesity are related to obesity， and the pathogenesis of daytime sleepiness may be related to LEP level changes.
阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome，OSAHS)是以在睡眠过程中反复发生呼吸暂停、低通气及微觉醒为特征的疾病[1]。OSAHS是睡眠障碍中最常見疾病[2]。肥胖为OSAHS患者首要危险因素[3]。日间嗜睡是OSAHS患者常见的临床表现之一，16%～22%的OSAHS患者存在日间嗜睡[4]。研究显示，OSAHS患者日间嗜睡与夜间缺氧程度及AHI相关，且患者BMI与AHI呈正相关[5]。但目前关于肥胖与日间嗜睡的独立关系的研究不多，且机制不清。肥胖程度与血清中瘦素浓度变化密切相关[6]。本研究通过对比是否伴肥胖的OSAHS患者日间嗜睡情况及血清瘦素水平，进一步探讨肥胖与OSAHS患者日间嗜睡关系及可能影响机制。
1 资料与方法
1.1 一般资料
研究对象均来自杭州市萧山区第一人民医院门诊、住院或健康体检中心，研究时间为2017年9月-2019年7月。OSAHS诊断标准：夜间7 h睡眠中呼吸暂停及低通气反复发作>30次或AHI≥5次/h，且以阻塞性呼吸暂停为主[7]。中国单纯性肥胖诊断标准：超重为BMI 25～26 kg/m2，肥胖为BMI>26 kg/m2。排除标准：心血管疾病、脑部疾病、老年痴呆、智力障碍、未控制的糖尿病、恶性肿瘤、甲状腺疾病、维生素缺乏、慢性阻塞性肺疾病、间质性肺疾病等。经多导睡眠图(PSG)及体重指数(BMI)测评，分为OSAHS伴肥胖组40例，OSAHS不伴肥胖组38例，单纯肥胖组42例。研究经医院伦理委员会同意，患者均签订知情同意书。, 百拇医药(郑艳文 邬海燕 胡立红 姜贻乾)