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1.
目的:对阻塞性睡眠呼吸暂停综合症(OSAS)咽部解剖途径进行分析。方法:探讨咽部解剖的方法,并从2012年1月到2013年1月这一年的时间段里,抽选出36例此类病患者进行多项检测并与36位无病史的人进行对照分析。结果:抽取的36例此类病患者均具有腭咽部狭窄的症状,其中大部分患者还合并有口咽部阻塞。结论:阻塞性睡眠呼吸暂停综合症的产生,与腭咽腔与口咽腔狭窄密切相关。  相似文献   

2.
目的:探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)组分关系。方法:对我院2003年1月至2010年7月39例诊断为0SAHS住院患者进行回顾性调查,30例同期住院病人为对照组,均记录年龄、性别,测量身高、体重、血压,检测空腹血糖、血脂,分析OSAHS患者合并MS组分情况。结果:1.OSAHS组与对照组比较,体重指数(BMI)、血压、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白Al升高,高密度脂蛋白胆固醇降低(P〈0.05);2.OSAHS组与对照组相比较,无MS组分比例低于对照组,差异有统计学意义(P〈0.05);3.OSAHS组与对照组相比较,OSAHS组合并MS组分,包括BMI〉25Kg/m2,血脂紊乱的比例,均高于对照组,差异有统计学意义(P〈0.05)。结论:OSAHS患者易合并代谢综合征组分。  相似文献   

3.
Objectives: To determine the prevalence of obstructive sleep apnea (OSA) in extremely overweight adolescents and to examine the effect of significant weight loss on OSA severity. Research Methods and Procedures: We reviewed the anthropometric and polysomnographic data on all extremely overweight adolescents who underwent laparoscopic Roux en Y gastric bypass surgery at Cincinnati Children's Hospital Medical Center from July 2001 to September 2004. Repeat polysomnograms were performed after significant weight loss. Comparisons were made between pre‐ and postoperative polysomnographic data. Results: Nineteen of 34 patients (55%) who underwent bariatric surgery were diagnosed with OSA. Subsequent to surgery, 10 of these patients returned for follow‐up polysomnographic testing. After significant weight loss (mean, 58 kg), OSA severity markedly decreased in all patients (median apnea‐hypopnea index at baseline vs. after weight loss, 9.1 vs. 0.65). Discussion: Our study indicated that OSA was highly prevalent in extremely overweight adolescents meeting eligibility criteria for bariatric surgery. The significant weight loss after gastric bypass was associated with a marked reduction in OSA severity.  相似文献   

4.
目的:探讨阻塞型睡眠呼吸暂停低通气综合征(OSAHS)与代谢综合征(MS)组分关系。方法:对我院2003年1月至2010年7月39例诊断为OSAHS住院患者进行回顾性调查,30例同期住院病人为对照组,均记录年龄、性别,测量身高、体重、血压,检测空腹血糖、血脂,分析OSAHS患者合并MS组分情况。结果:1.OSAHS组与对照组比较,体重指数(BMI)、血压、血清甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1升高,高密度脂蛋白胆固醇降低(P<0.05);2.OSAHS组与对照组相比较,无MS组分比例低于对照组,差异有统计学意义(P<0.05);3.OSAHS组与对照组相比较,OSAHS组合并MS组分,包括BMI≥25Kg/m2,血脂紊乱的比例,均高于对照组,差异有统计学意义(P<0.05)。结论:OSAHS患者易合并代谢综合征组分。  相似文献   

5.
目的:探讨儿童阻塞性睡眠呼吸暂停/低通气综合征(OSAHS)与肥胖的相关性。方法:收集单纯性肥胖儿童120例和体重正常儿童110例作为研究对象,进行统一的体格检查和专科检查,并进行多导睡眠监测记录阻塞性呼吸暂停指数(OAI)、呼吸暂停/低通气指数(AHI)、中枢性呼吸暂停指数(CAI)、最低血氧饱和度(LSa O2)和睡眠效率。结果:肥胖组OSAHS患病率为58.33%显著高于对照组的31.82%,差异有统计学意义(P0.05);OAI、AHI、CAI均显著高于对照组,而LSa O2、睡眠效率指标显著低于对照组,差异均有统计学意义(均P0.05);多因素回归分析显示,肥胖、扁桃体增生、腺样体增生是导致OSAHS的独立危险因素,差异有统计学意义(均P0.05)。结论:肥胖是儿童OSAHS发病的重要影响因素,特别是合并扁桃体肿大或腺样体肿大的患儿应注意预防OSAHS的发生。  相似文献   

6.
目的:探讨儿童及成人阻塞型睡眠呼吸暂停低通气综合症(OSAHS)发病原因、睡眠呼吸紊乱严重程度及合并代谢异常程度的差别。方法:对我院2003年1月1日至20]0年7月1日71例诊断为OSAHS住院患者进行回顾性调查,登记年龄、性男日、发病原因、血压、白细胞计数、中性粒细胞比率、淋巴细胞比率、呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度、微觉醒指数。根据年龄进行分组,年龄〈18岁者为A组,年龄≥18岁者为B组。比较两组发病原因、睡眠呼吸紊乱及合并代谢异常程度的差剐。结果:1.A组慢性扁桃体炎和(或)腺样体肥大发生率明显高于B组(P〈O.01),鼻中隔偏曲发生率明显低于B组(P〈0.01)。2.与B组比较,A组AHI及微觉醒指数降低,夜间最低血氧饱和度升高(P〈0.01);3.与B组比较,A组高血压、中性粒细胞比率、谷丙转氨酶比例降低(P〈0.05)。结论:A组睡眠呼吸紊乱程度及代谢异常较B组程度轻,更需关注成人阻塞型睡眠呼吸暂停低通气综合症的综合治疗。  相似文献   

7.
阻塞性睡眠呼吸暂停综合征临床监测分析   总被引:1,自引:0,他引:1  
程玮  杨梦雨  闫堃 《现代生物医学进展》2007,7(12):1856-1857,1860
目的:探讨阻塞性睡眠呼吸暂停综合征患者的临床特征及评价疗效。方法:回顾分析70例阻塞性睡眠呼吸暂停综合征患者PSG监测数据。结果:随着呼吸紊乱指数的增加,年龄、体重指数、最长呼吸暂停时间、最低SaO_2%、平均SaO_2%下降等指标在轻度与中、重度SAS之间差异显著;70例患者中伴有高血压52.9%、糖尿病5.7%、冠心病21.4%。结论:OSAS是一种具有潜在危险的疾痛,对OSAS早期诊断治疗是预防发生严重并发症的关键。  相似文献   

8.
目的:探讨儿童及成人阻塞型睡眠呼吸暂停低通气综合症(OSAHS)发病原因、睡眠呼吸紊乱严重程度及合并代谢异常程度的差别。方法:对我院2003年1月1日至2010年7月1日71例诊断为OSAHS住院患者进行回顾性调查,登记年龄、性别、发病原因、血压、白细胞计数、中性粒细胞比率、淋巴细胞比率、呼吸暂停低通气指数(AHI)、夜间最低血氧饱和度、微觉醒指数。根据年龄进行分组,年龄<18岁者为A组,年龄≥18岁者为B组。比较两组发病原因、睡眠呼吸紊乱及合并代谢异常程度的差别。结果:1.A组慢性扁桃体炎和(或)腺样体肥大发生率明显高于B组(P<0.01),鼻中隔偏曲发生率明显低于B组(P<0.01)。2.与B组比较,A组AHI及微觉醒指数降低,夜间最低血氧饱和度升高(P<0.01);3.与B组比较,A组高血压、中性粒细胞比率、谷丙转氨酶比例降低(P<0.05)。结论:A组睡眠呼吸紊乱程度及代谢异常较B组程度轻,更需关注成人阻塞型睡眠呼吸暂停低通气综合症的综合治疗。  相似文献   

9.
目的:探讨H型高血压与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的相互关系。方法:选择2013年10月至2014年8月在上海市浦南医院心内科就诊的78例高血压住院患者,血浆同型半胱氨酸(Hcy)水平≥10μmol/L为H型高血压、血浆Hcy水平10μmol/L为单纯性高血压。两者分别用便携式睡眠监测仪(PMD)检测,比较两组结果的差异。结果:H型高血压组的呼吸暂停低通气指数(AHI)高于单纯性高血压组(P0.05),H型高血压组的OSAHS发病率与单纯组无差异(P0.05),在有OSAHS的高血压病人中,H型高血压组有较高的中重度OSAHS的发病率(P0.01)。结论:在高血压患者中,没有发现血浆Hcy水平与OSAHS相关。但是一旦存在OSAHS,则合并H型高血压患者中出现中重度OSAHS的概率较高。  相似文献   

10.
目的:观察手术治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的手术治疗方法及临床效果,为临床治疗提供依据。方法:选取我院2010年2月~2013年1月期间收治的儿童阻塞性睡眠呼吸暂停低通气综合征患者56例做研究对象,对患儿的手术治疗方法及手术前后呼吸暂停指数、最低血氧饱和度及呼吸暂停低通气指数平均值进行记录和分析,比较其临床疗效情况。结果:三组患儿术后呼吸暂停指数、伴最低血氧饱和度、呼吸暂停低通气指数与术前比较,差异明显具有统计学意义,术后优于术前。中、重度鼻咽气道狭窄程度比较,术后较术前疗效显著,差异明显具有统计学意义(P0.05)。结论:儿童阻塞性睡眠呼吸暂停低通气综合征手术后呼吸暂停指数、伴最低血氧饱和度、呼吸暂停低通气指数得到显著改善,是治疗最佳方案,建议推广应用。  相似文献   

11.
目的:研究阻塞性睡眠呼吸暂停综合征与高血压的临床关系及相关机制。方法:将258例鼾症患者分为三组:单纯鼾症对照组(N组)、单纯OSAHS组(O组)、OSAHS合并高血压组(O+H组)。对三组患者进行临床基础资料收集,ESS问卷调查及EP评分,多导睡眠监测及血压测定。结果:三组鼾症患者之间年龄、性别、吸烟、饮酒差异无统计学意义(P>0.05),OSAHS组及OSAHS+HT组体重指数及颈围明显高于单纯鼾症组,差异有统计学意义(P<0.05);与单纯鼾症组比较,OSAHS组及OSAHS+HT组的EP评分、AHI、LaSO2(%)、MSaO2、Ts90%差异明显有统计学意义(P<0.05);与对照组相比OSAHS组及OSAHS+HT组睡眠前后收缩压和舒张压升高,差异有统计学意义(P<0.05)。结论:阻塞性睡眠呼吸暂停综合征与高血压关系密切,慢性间歇缺氧是引起高血压的核心机制。  相似文献   

12.
目的:研究持续正压通气治疗阻塞性睡眠呼吸暂停综合征(OSAHS)并发心房纤颤的临床疗效。方法:选取2013年1月到2014年1月我院收治的OSAHS并发心房纤颤患者60例,按照随机数字表法将患者分为实验组和对照组,每组30例。对照组给予常规治疗,实验组在对照组的基础上给予持续正压通气治疗,两组均治疗1年。分析治疗前、后两组心率(HR)、血氧饱和度(SPO2)、左心射血分数(LVEF)、脑钠肽(BNP),并比较两组心房纤颤转复率、复发率和不良反应。结果:治疗后实验组HR、SPO2、LVEF以及BNP显著优于对照组,两组比较差异具有统计学意义(P0.05);治疗后实验组心房纤颤转复率显著高于对照组,心房纤颤复发率显著低于对照组,两组比较差异具有统计学意义(P0.05);两组不良反应发生率比较无统计学意义(P0.05)。结论:持续正压通气治疗OSAHS并发心房纤颤具有较好的效果,有利于改善心功能,提高心房纤颤转复率降低房纤颤复发率。  相似文献   

13.
Obstructive sleep apnea has historically been considered a male disease. Although most studies have shown male predominance, obstructive sleep apnea is highly prevalent in women, increasing with age and varying with physiologic status among other factors. Obstructive sleep apnea is associated with significant symptoms and health consequences in women yet remains underdiagnosed in women in part due to differences in presenting symptoms, differences in polysomnographic findings, and/or sociocultural factors. This review will discuss the epidemiology, pathophysiology, clinical presentation, diagnostic findings, and treatment of obstructive sleep apnea, focusing on sex and gender differences.  相似文献   

14.
A sample of 32 obstructive sleep apnea patients (27 males, 5 females) was assessed with overnight polysomnography and the Multiple Sleep Latency Test (MSLT), an objective measure of daytime sleepiness. Patients also participated in a maximal exercise test, which served as an objective indicator of physical fatigue. The Fatigue Severity Scale (FSS) was used as a subjective measure of fatigue. Subjective fatigue ratings were significantly correlated with percent of predicted maximum heart rate achieved during exercise testing, suggesting that self-reported fatigue in apnea patients may refer to reduced physical fitness. FSS scores and exercise testing results were not significantly correlated with the MSLT, indicating that daytime fatigue and daytime sleepiness are independent problems in apnea patients. Participants self-reported a high level of fatigue, and exercise testing revealed decreased physical work capacity among apnea patients, but objective and subjective indicators of fatigue were not significantly correlated with apnea severity. A higher percentage of REM sleep predicted greater work capacity.  相似文献   

15.
目的:探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)血压变异性及运动心肺功能与病情的相关性分析。方法:选取2017年2月~2018年11月期间我院收治的OSAHS患者119例为研究对象,根据每小时睡眠呼吸暂停次数(AHI)将患者分为轻度组(AHI:5~20次/h,n=45)、中度组(AHI:21~40次/h,n=39)、重度组(AHI:40次/h,n=35),检测所有研究对象的血压变异性及运动心肺功能,并作组间比较。采用Pearson积矩相关分析OSAHS患者血压变异性及运动心肺功能与病情的相关性。结果:OSAHS患者收缩压(SBP)昼、舒张压(DBP)夜以及中度组、重度组SBP夜均高于对照组(P0.05);重度组DBP夜以及中度组、重度组SBP昼、SBP夜高于轻度组(P0.05);重度组SBP夜、SBP昼、DBP夜高于中度组(P0.05);而各组DBP昼整体比较差异无统计学意义(P0.05)。OSAHS患者最大摄氧量占预计值百分比(VO2max%pred)、最大摄氧量峰值占预计值百分比(peak VO2%pred)、无氧阈值(AT)、摄氧量功率比值(VO2/WR)、呼吸储备(VEmax/MVV)均低于对照组,且随病情严重程度的增加而降低(P0.05),OSAHS患者二氧化碳通气当量(VE/VCO2)高于对照组,且随病情严重程度的增加而升高(P0.05)。Pearson积矩相关分析结果显示,OSAHS患者病情严重程度与SBP昼、SBP夜、DBP夜、VE/VCO2呈正相关(P0.05),与VO2max%pred、peakVO2%pred、AT、VEmax/MVV、VO2/WR呈负相关(P0.05),与DBP昼无相关性(P0.05)。结论:血压变异性及运动心肺功能指标可反映OSAHS患者病情严重程度,可考虑作为早期监测指标并参考指导治疗。  相似文献   

16.
Objective: Obstructive sleep apnea (OSA) is associated with obesity, sympathetic activation, systemic inflammation, and cardiovascular morbidity. Obesity, β‐adrenergic agonists, and inflammation are linked to decreased expression and/or secretion of an adipose tissue‐derived antiatherogenic hormone, adiponectin. The purpose of the study was to investigate whether OSA affected plasma levels of adiponectin, which might help explain OSA‐associated cardiovascular morbidity. Research Methods and Procedures: We randomly selected 68 otherwise healthy male subjects, either with moderate/severe OSA [apnea‐hypopnea index (AHI) ≥ 20; n = 35] or without OSA (AHI ≤ 5; n = 33). The diagnosis of OSA was made based on prospective full polysomnography. Adiponectin was measured before polysomnography between 8 and 10 PM . Results: AHI was higher in the OSA group (49.5 ± 4.4 vs. 2.9 ± 0.4 events/h; p < 0.001). OSA subjects were also more obese, with greater BMI (33 ± 1 vs. 30 ± 1; p = 0.016) and percentage body fat (29 ± 1% vs. 26 ± 1%; p = 0.030). Adiponectin levels were 7.67 ± 0.73 and 6.33 ± 0.51 μg/mL in the OSA and non‐OSA groups, respectively, and this difference was significant in covariate analysis (taking into account age, hemodynamic characteristics, measures of body fat, and OSA severity) (p = 0.009). After excluding from both groups the subjects with extreme BMI, such that the OSA and non‐OSA study cohorts had similar BMI and percentage body fat, subjects with OSA had significantly higher plasma adiponectin (8.49 ± 0.92 vs. 6.32 ± 0.55 μg/mL; p = 0.042), differences also evident in covariate analysis (p = 0.017). Discussion: Plasma adiponectin levels are elevated in otherwise healthy subjects with OSA. Therefore, low adiponectin is unlikely to explain the association between OSA and cardiovascular disease.  相似文献   

17.
Objective: To determine the prevalence of sleep apnea in morbidly obese patients and its relationship with cardiac arrhythmias. Research Methods and Procedures: Fifty‐two consecutive morbidly obese (body mass index ≥ 40 kg/m2) outpatients from the Obesity Clinic of the National Institute of Nutrition Salvador Zubirán underwent two nights of polysomnography with standard laboratory techniques. Electrocardiographic polysomnography signals (Lead II) were evaluated by two experienced cardiologists, and sleep complaints were measured with a standard sleep questionnaire (Sleep Disorders Questionnaire). In order to make comparisons between groups with different severities of sleep‐disordered breathing, we classified the patients in four groups using the apnea‐hypopnea index (AHI): Group 1, AHI 5 < 15 (n = 10); Group 2, AHI 15 < 30 (n = 10); Group 3, AHI 30 < 65 (n = 14); Group 4, AHI ≥ 65 (n = 17). Results: A wide range of sleep‐disordered breathing, ranging from AHI of 2.5 to 128.9 was found. Ninety‐eight percent of the sample (n = 51) had an AHI ≥ 5 (mean = 51 ± 37), and 33% had severe sleep apnea with AHI ≥ 65 with a mean nocturnal desaturation time of <65% over 135 minutes. Electrocardiographic abnormalities were present in 31% of the patients. Cardiac rhythm alterations showed an association with the level of sleep‐disordered breathing and oxygen desaturation. Discussion: We conclude that there is a high prevalence of sleep apnea in morbidly obese patients and that the risk for cardiac arrhythmias increases in this population in the presence of a severe sleep apnea (AHI ≥ 65) with severe oxygen desaturation (Sao 2 ≤ 65%).  相似文献   

18.
目的:对比分析药物干预和手术切除治疗儿童阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的临床疗效。方法:应用随机数字表法将2015年2月至2017年11月经本院确诊的100例OSAHS患儿分为药物组、手术组,每组50例。药物组采用孟鲁司特钠治疗6个月,手术组行腺样体和扁桃体切除术。6个月后比较两组患儿多导睡眠图监(PSG)的监测结果和生活质量情况,比较两组疗效评定情况,记录手术组无效及并发症的原因。结果:6个月后,药物组、手术组患儿呼吸暂停低通气指数(AHI)、阻塞性呼吸暂停指数(OAI)、微觉醒指数(MAI)和睡眠呼吸紊乱指数(RDI)较治疗前降低,且手术组患儿AHI低于药物(P0.05)。手术组患儿6个月后睡眠障碍、对监护人的影响、身体症状评分较治疗前降低,且低于药物组(P0.05),而药物组治疗前后OSA-18评分各指标比较差异无统计学意义(P0.05)。手术组患儿总有效率为90.00%(45/50),高于药物组的50.00%(25/50),差异有统计学意义(P0.05)。手术组患儿有出血现象的4例、伴舌后坠2例、上呼吸反复道感染6例和鼻炎5例,无效的5例患儿为伴有肥胖的重度OSAHS。结论:对于OSAHS患儿,药物干预和手术切除均可改善患儿PSG指标水平,但手术切除治疗可提高患儿生活质量和治疗有效率。  相似文献   

19.
Objective: To evaluate the effect of plasma leptin, nonsterified fatty acids (NEFAs), and tumor necrosis factor‐receptor 1 (TNFR1) on plasma insulin and insulin‐resistance status in children. Research Methods and Procedures: One thousand thirty‐two children (521 boys and 511 girls) were included in this study. We measured plasma insulin and leptin levels by radioimmunoassay, plasma NEFA levels by enzymatic acyl‐coenzyme A synthase—acyl‐coenzyme A oxidase spectrophotometric methods, and TNFR1 levels by enzyme‐linked immunosorbent assay. We calculated insulin resistance index (IRI) using homeostasis model assessment and calculated insulin‐resistance syndrome summary score (IRS) by adding the quartile ranks from the distribution of systolic blood pressure (BP), serum triglyceride, high‐density lipoprotein‐cholesterol (inverse), and insulin levels. Results: Overweight children had higher BP, plasma leptin, and insulin levels and higher IRI and IRS than normal‐weight children. Plasma leptin and TNFR1 were positively correlated with insulin levels, IRI, and IRS. The correlation coefficients of leptin and TNFR1 in IRI were 0.53 and 0.12, respectively, for boys and 0.25 and 0.18, respectively, for girls. In multivariate regression analyses, TNFR1 was positively associated with insulin level and IRI in girls; NEFA was positively associated only with IRS. Plasma leptin levels were significantly positively associated with insulin levels, IRI, and IRS, even after adjusting for BMI and other potential confounders. Discussion: Overweight children had higher BP, plasma insulin, and leptin levels and adverse insulin‐resistance status than normal‐weight children. Plasma leptin levels, rather than NEFA and TNFR1, may play a significant role in the development of hyperinsulinemia and insulin resistance in children.  相似文献   

20.
摘要 目的:探讨学龄前阻塞性睡眠呼吸暂停低通气综合征(OSAHS)儿童与正常儿童肠道菌群的差异。方法:选取2023年7月至2023年11月期间新疆医科大学第一附属医院儿科门诊收治的学龄前OSAHS儿童30例作为OSAHS组,选取同期于新疆医科大学第一附属医院健康管理中心体检健康的儿童30例作为对照组。利用16SrDNA扩增子测序技术对肠道菌群进行分析。采用Spearman法分析睡眠质量与肠道菌群门、属水平丰度的相关性。结果:OSAHS组和对照组共发现2588个扩增子序列变异(ASVs),OSAHS组检出特有ASVs 1034个,对照组检出特有ASVs 1554个。OSAHS组Chao1指数和Observed otus指数显著低于对照组(P<0.05),两组间Shannnon指数、Simpson指数、Goods coverage指数、Peilou-e指数均差异无统计学意义(P>0.05)。OSAHS组与对照组间肠道菌群群落结构存在显著差异(P<0.05)。在门水平上,OSAHS组拟杆菌门的相对丰度低于对照组,厚壁菌门的相对丰度、厚壁菌门/拟杆菌门的比例高于对照组(P<0.05)。在属水平上,OSAHS组与对照组组优势菌群相对分度比较差异无统计学意义(P>0.05)。在门水平上,睡眠质量与拟杆菌门呈正相关(P<0.05)。在属水平上,睡眠质量与双歧杆菌属、乳杆菌属呈负相关,与拟杆菌属呈正相关(P<0.05)。阻塞性呼吸暂停低通气指数(OAHI)与肠杆菌属呈负相关(P<0.05)。最低血氧饱和度(LSaO2)与肠杆菌属呈正相关(P<0.05)。平均血氧饱和度(MSaO2)与X.Eubacterium._eligens_group呈正相关(P<0.05)。结论:与正常儿童的肠道菌群的种类和相对丰度相比,学龄前OSAHS儿童的厚壁菌门/拟杆菌门比例升高,可能存在肠道菌群失调。睡眠质量在门、属水平上与拟杆菌门、双歧杆菌属、乳杆菌属明显相关。  相似文献   

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