OSAHS嗜睡评价.doc

阻塞性睡眠呼吸暂停低通气综合征患者白天嗜睡程度的评价及意义 鲁建光，韩晶，王超 （哈尔滨医科大学附属第二医院耳鼻咽喉科，哈尔滨，150086） 本文发表于《中国临床康复》2004年第36期 摘要 目的:阻塞性睡眠呼吸暂停低通气综合征（Obstructive Sleep Apnea-Hypopnea Syndrome，OSAHS）患者经常出现白天嗜睡，其程度与病情密切相关。本研究探讨OSAHS患者白天嗜睡程度的评价方法及其临床意义。方法:疑似OSAHS的患者65例，行多导睡眠图（polysomnography，PSG）检查，符合OSAHS诊断标准者57例，纳入本研究，其余8例作为对照组（非OSAHS组）。排除标准为有头部创伤、癫痫、脑肿瘤、脑出血、代谢中毒、感染等病史，以及服用影响神经系统兴奋性药物病史者。OSAHS组57例，根据PSG结果分为轻度组（15例）、中度组（9例）和重度组（33例）3组。采用Epowrth嗜睡评估表(Epworth sleepiness scale, ESS)对所有65例患者进行测评，比较非OSAHS组及不同程度OSAHS组ESS评分的差异及其与疾病程度的相关性。结果: ESS评分与呼吸紊乱指数（apnea-hypopnea index, AHI）呈正相关(r=0.81，P0.01)；与睡眠中最低血氧饱和度（SpO2）呈负相关(r=－0.62，P0.01)；OSAHS组ESS评分显著高于非OSAHS组（t=2.82，P0.01）；重度OSAHS组ESS评分显著高于中度组，中度OSAHS组ESS评分显著高于轻度组，3组之间ESS评分差异有非常显著性意义(F=19.19，P0. 01)；结论: ESS是评价OSAHS患者白天嗜睡程度的较好指标，ESS评分对于OSAHS的轻重程度有明显的预测价值。 主题词:睡眠呼吸暂停，阻塞性；过度嗜睡性障碍；多道睡眠描记术 The evaluation of daytime sleepiness and its meaning in patients with Obstructive Sleep Apnea-Hypopnea Syndrome Jian-guang Lu, Jing Han, Chao Wang, Department of Otorhinolaryngology, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086,China Abstract Objective: The patients who with the OSAHS often appear daytime sleepiness. Its degree is pertinent to the state of an illness. The disquisition investigate the evaluation method of daytime sleepiness and its meaning in patients with OSAHS. Methods: 65 patients who seem to be ill with OSAHS had been inspected with the PSG，57 cases of these patients accorded the diagnosis standard of OSAHS, they were brought into the investigation. The others 8 cases were brought into the antitheses group. The standard of remove comprise the patients who with skull wound, falling sickness, encephalon tumor, encephalon bleeding, poisoning, infect and take medicine of center nerve system. The 57 patients who brought into the OSAHS group were separated into 3 groups, low-grade (15 cases), middle-grade (9 cases) and serious-grade (33 cases). All of these 65 patients had been evaluated with the ESS. The difference of ESS between the