胡碧 1王茂筠 2王怡唯 1张润 1雷飞 1梁宗安1
作者信息
- 1. 610041四川省成都市,四川大学华西医院呼吸与危重症医学科
- 2. 611730四川省成都市,成都上锦南府医院呼吸与危重症医学科
- 折叠
摘要
Abstract
Objective To probe into the clinical significance of nocturnal oximetry saturation (SaO2) monitoring in patients with metabolic syndrome (MS) associated with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods The subjects enrolled in this study were 196 consecutive patients who complained about snoring and underwent polysomnography (PSG) in the outpatient of West China Hospital,Sichuan University from June to August 2015.We obtained the baseline characteristics and medical history of the patients.All the patients received PSG and determination of nocturnal SaO2 with Shuqitong pulse oximetry at the same time,and their blood glucose and blood lipid monitoring and fasting venous blood samples collected on the following morning were measured.We divided the patients into 3 groups based on their BMI and accompanied MS conditions:normal weight group (n =80),obesity without MS group (n =46),and obesity with MS group (n =70).In accordance with the apnea-hypopnea index (AHI),the obese patients were divided into non-OSAHS group (n =25) and OSAHS group (n =91).We adopted receiver operating characteristic (ROC) curves to evaluate the diagnostic value of oxygen desaturation index (ODI) on OSAHS in normal weight group,obesity without MS group,and obesity with MS group.Results Patients in the obesity without MS group were older,and they had longer neck circumference and waist circumference,higher ratios of maxillofacial abnormalities and pharyngeal stenosis compared with those in the normal weight group did (P ＜ 0.01);patients in the obesity with MS group were older,and they had longer neck circumference and waist circumference,higher ratios of maxillofacial abnormalities and pharyngeal stenosis,higher proportion of tonsil or tongue body hypertrophy than those in the normal weight group did (P ＜ 0.01);they had longer waist circumference than those in the obesity without MS group did (P ＜ 0.01).The detection rate of OSAHS differed significantly in the normal weight group [37.5％ (30/80)],obesity without MS group [60.9％ (28/46)] and obesity with MS group [90.0％ (63/70)] (x2 =43.58,P ＜0.001),specifically,compared with the normal weight group,both the obesity without MS group and obesity with MS group had higher detection rate of OSAHS (x2 =6.42,P ＜ 0.016;x2 =43.68,P ＜ 0.016);obesity with MS group had higher detection rate of OSAHS than obesity without MS group did (x2 =13.93,P ＜0.016).AHI,SIT90 and ODI of obesity without MS group were higher than those of the normal weight group (P ＜ 0.05).Obesity with MS group has higher AHI,SIT90 and ODI and lower mean SaO2 (MSaO2),lowest SaO2 (LSaO2) than normal weight group and obesity without MS group did (P ＜ 0.05).Among the obese patients,the incidence of MS was much higher in the OSAHS group than that in the non-OSAHS group [69.2％ (63/91) vs.28.0％ (7/ 25),x2 =13.93,P ＜ 0.05].MSaO2,LSaO2,SIT90 and ODI in the non-OSAHS group were significantly different from those in the OSAHS group (P ＜0.05).The AUC of ROC curves for ODI's diagnostic value of OSAHS in normal weight group,obesity without MS group and obesity with MS group was 0.963 [95％CI (0.914,1.000)],0.970 [95％CI (0.929,1.000)] and 0.959 [95％ CI (0.907,1.000)],respectively.Conclusion Nocturnal SaO2 monitoring is of certain clinical significance for initial diagnosis of MS patients associated with OSAHS.关键词
代谢综合征X/睡眠呼吸暂停,阻塞性/人体质量指数/睡眠/肥胖症Key words
Metabolic syndrome X/Sleep apnea, obstructive/Body mass index/Sleep/Obesity分类
医药卫生
