绝经期女性阻塞性睡眠呼吸暂停的特征以及影响因素分析

发布时间：2018-08-12 14:35

【摘要】：目的:探讨绝经期女性阻塞性睡眠呼吸暂停的临床特征,以及其相关风险因素。对象:收录2014年1月至2017年1月就诊于吉林大学第一临床医院呼吸内科睡眠中心绝经期女性患者,停经一年以上,行多导睡眠监测,按照2011年阻塞性睡眠呼吸暂停诊治指南,诊断为阻塞性睡眠呼吸暂停(Obstructive sleep apnea,OSA)患者,排除具有颌面部畸形,神经肌肉疾病,以往进行过鼾症方面的手术,以及接受持续气道正压通气治疗,有其他呼吸系统疾病史的患者。173名受试者入组,根据绝经期时间,绝经一年以上十年以下者为绝经早期组,共87例,平均年龄(53.4±3.5)岁;绝经十年以上者为绝经晚期组,共86例,平均年龄(63.7±4.0)岁。方法:测量受试者身高、体重、颈围、腹围,应用埃普沃思嗜睡量表(Epworth sleepiness scale,ESS)评价受试者嗜睡程度,多导睡眠监测法检测受试者睡眠呼吸暂停低通气指数(Apnea-hypopnea index AHI)、低通气指数(Hypopnea index,HI)占AHI的比率、夜间最低血氧饱和度、最长呼吸暂停时间,晨起检测受试者收缩压和舒张压。进一步分别在两组受试者中进行颈围、腹围以及收缩压、舒张压与AHI的相关分析。结果:与绝经早期组相比,绝经晚期组OSA受试者表现出嗜睡程度更高(p0.05)以及更高的AHI(p0.05),差别具有统计学意义;HI/AHI在绝经早期组明显高于绝经晚期组(p0.001);夜间最低血氧饱和度在绝经晚期组较绝经早期组表现为更低(p0.05),两组受试者最长呼吸暂停时间无统计学差异(p0.05)。腹围和收缩压在绝经晚期组高于绝经早期组(p0.05,p0.05);相关分析结果显示,在绝经期两组患者,腹围与AHI呈正相关(r=0.907,p0.001);收缩压与AHI之间呈正相关(r=0.870,p0.001)。结论:1、绝经期女性OSA严重程度随绝经期延长逐渐加重。2、肥胖是绝经期女性OSA危险因素之一。3、绝经期女性OSA严重度增加高血压发病的风险。
[Abstract]:Objective: to investigate the clinical features and risk factors of obstructive sleep apnea (OSAS) in menopausal women. Participants: from January 2014 to January 2017, postmenopausal female patients in the sleep center of Department of Apnea, the first Clinical Hospital of Jilin University, received polysomnography and polysomnography according to the guidelines for diagnosis and treatment of obstructive sleep apnea in 2011. Patients diagnosed with obstructive sleep apnea (Obstructive sleep apnea) were excluded from maxillofacial malformations, neuromuscular diseases, previous snoring operations, and continuous positive airway pressure ventilation. According to the period of menopause, 87 subjects with an average age of (53.4 卤3.5) years, who had a history of other respiratory diseases, were in the early menopause group, and 86 patients had a postmenopausal period of more than ten years, according to the period of menopause, the average age was (53.4 卤3.5) years. The average age was (63.7 卤4.0) years. Methods: the height, weight, neck circumference, abdominal circumference of the subjects were measured. The degree of somnolence was evaluated by (Epworth sleepiness scale. The ratio of Apnea-hypopnea index AHI), hypopnea index (Hypopnea index HI) to AHI, nocturnal minimum oxygen saturation, longest apnea time, systolic and diastolic blood pressure were measured by polysomnography. The relationship between neck circumference, abdominal circumference, systolic blood pressure, diastolic blood pressure and AHI was further analyzed in both groups. Results: compared with the early menopausal group, The subjects of OSA in late menopausal group showed higher somnolence (p0. 05) and higher AHI (p0. 05), the difference was statistically significant (P 0. 001), and the nocturnal minimum oxygen saturation was higher in the early menopausal group than in the postmenopausal period group (p0. 001), and the nocturnal minimum oxygen saturation in the late menopausal group was higher than that in the postmenopausal group. There was no significant difference in the longest apnea time between the two groups (p0.05). The abdominal circumference and systolic blood pressure were higher in the late menopausal group than in the early menopausal group (p0.05), the results of correlation analysis showed that the abdominal circumference was positively correlated with AHI in the menopausal patients (r = 0.907 / p0.001), and the systolic blood pressure was positively correlated with AHI (r = 0.870 / p 0.001). Conclusion the severity of OSA in menopausal women increases with the prolongation of menopausal period. Obesity is one of the risk factors of OSA in menopausal women. The severity of OSA in menopausal women increases the risk of hypertension.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766

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