高原列车司乘人员中阻塞性睡眠呼吸暂停低通气综合征患者睡眠障碍情况分析
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摘要
目的:研究高原列车司乘人员中OSAHS患者睡眠障碍的情况。方法:选取高原列车司乘人员其中阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)患者和非OSAHS患者各60例,利用7 h多导睡眠监测和Epworth量表进行评分分析高原列车司乘人员中OSAHS患者Epworth评分、AHI指数、Sa O2(%)及睡眠分期结构的情况。结果:实验组Epworth嗜睡量表评分为(16.85±4.20)分,暂停低通气指数(Apnea Hypopnea Index,AHI)为(18.87±9.67),动脉血氧饱和度(Sa O2)为(82.85±7.71)%;对照组的Epworth评分为(4.38±1.87)分,暂停低通气指数Apnea Hypopnea Index(AHI)为2.35±0.95,动脉血氧饱和度(Sa O2)为(91.13±0.72)%;两组的Epworth评分和AHI指数比较均有统计学意义。实验组Ⅱ期非快动眼睡眠占总睡眠时间百分比为(57.50±1.87)%;Ⅲ期非快动眼睡眠占总睡眠时间百分比为(5.26±1.94)%;Ⅳ期非快动眼睡眠占总睡眠时间百分比为(4.43±2.99%);对照组Ⅱ期非快动眼睡眠占总睡眠时间百分比为(50.37±2.99)%;Ⅲ期非快动眼睡眠占总睡眠时间百分比为(5.30±1.51)%;Ⅳ期非快动眼睡眠占总睡眠时间百分比为(12.50±1.71)%;两组的Ⅱ期非快动眼睡眠占总睡眠时间百分比和Ⅳ期非快动眼睡眠占总睡眠时间百分比比较均具有统计学意义。结论:在司乘人员从平原进入高原后,因缺氧发生动脉血氧饱和度降低而导致高原列车司乘人员均有不同程度的睡眠障碍,而OSAHS患者的睡眠障碍更加明显。
Objective: To investigate the sleep disturbances of obstructive sleep apnea-hypopnea syndrome(OSAHS) patients in the plateau train division.Methods: The plateau train passengers among non OSAHS patients and OSAHS patients 60 cases in each,and the scores of Epworth,AHI index,SaO_2(%) and sleep stage structure of OSAHS patients in plateau train were analyzed by using the polysomnography and Epworth scale of OSAHS.Results: The experimental group Epworth sleepiness scale score was 16.85 + 4.20,Apnea Hypopnea Index(AHI) was 18.87 + 9.67,arterial oxygen saturation(Sa O2) was(82.85 + 7.71) %.In the control group,the Epworth score was 4.38 + 1.87,Apnea Hypopnea Index(AHI) was 2.35 + 0.95,arterial oxygen saturation(Sa O2) was(91.13 +0.72) %.Compared with the control group,Epworth score and AHI index were statistically significant in experimental group.In the experimental group,NREM sleep percentage of total sleep time of stage Ⅱ was(57.50 + 1.87) %,NREM sleep percentage of total sleep time of stage Ⅲ was(5.26 + 1.94) %,NREM sleep percentage of total sleep time for advanced stage Ⅳ was(4.43 + 2.99%).In the control group,the NREM sleep percentage of total sleep time was(50.37 + 2.99) %,(5.30 + 1.51) % and(12.50 + 1.71) %,respectively.The stage Ⅱ NREM sleep percentage and stage IV NREM sleep percentage of total sleep time were statistically significant in two groups.Conclusion: By staff from the plains into the plateau after the occurrence of arterial oxygen saturation decreased due to hypoxia phenomenon,cause sleep disturbances plateau train passengers in varying degrees,and sleep disorders in patients with OSAHS is significantly.
Objective: To investigate the sleep disturbances of obstructive sleep apnea-hypopnea syndrome(OSAHS) patients in the plateau train division.Methods: The plateau train passengers among non OSAHS patients and OSAHS patients 60 cases in each,and the scores of Epworth,AHI index,SaO_2(%) and sleep stage structure of OSAHS patients in plateau train were analyzed by using the polysomnography and Epworth scale of OSAHS.Results: The experimental group Epworth sleepiness scale score was 16.85 + 4.20,Apnea Hypopnea Index(AHI) was 18.87 + 9.67,arterial oxygen saturation(Sa O2) was(82.85 + 7.71) %.In the control group,the Epworth score was 4.38 + 1.87,Apnea Hypopnea Index(AHI) was 2.35 + 0.95,arterial oxygen saturation(Sa O2) was(91.13 +0.72) %.Compared with the control group,Epworth score and AHI index were statistically significant in experimental group.In the experimental group,NREM sleep percentage of total sleep time of stage Ⅱ was(57.50 + 1.87) %,NREM sleep percentage of total sleep time of stage Ⅲ was(5.26 + 1.94) %,NREM sleep percentage of total sleep time for advanced stage Ⅳ was(4.43 + 2.99%).In the control group,the NREM sleep percentage of total sleep time was(50.37 + 2.99) %,(5.30 + 1.51) % and(12.50 + 1.71) %,respectively.The stage Ⅱ NREM sleep percentage and stage IV NREM sleep percentage of total sleep time were statistically significant in two groups.Conclusion: By staff from the plains into the plateau after the occurrence of arterial oxygen saturation decreased due to hypoxia phenomenon,cause sleep disturbances plateau train passengers in varying degrees,and sleep disorders in patients with OSAHS is significantly.
引文
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[10]吴天一,李素芝,李文翔.玉树地震灾后重建工人中高原头痛及与高原睡眠关系的研究[J].中国医药科学,2014,4(18):7-10.
[2]陈勇胜,王生成.高原低氧环境对睡眠和脑功能的影响[J].空军医学杂志,2012,28(3):150-153,158.
[3]刘桂兰,宋志强,韩国玲,等.高原地区大学生睡眠质量调查[J].中国心理卫生杂志,2007,21(1):53.
[4]陈健,吴世政.高原睡眠呼吸障碍与卒中[J].中国卒中杂志,2007,2(12):990-992.
[5]哈振德,简新琼,张西洲,等.海拔1 400 m某部官兵睡眠呼吸暂停低通气综合征患病率调查[J].临床军医杂志,2006,34(3):335-337.
[6]梁海君,孙明光,汤忠国,等.急进高原驻训官兵常见病的防治对策[J].东南国防医药,2011,13(3):264.
[7]王驰,王成彬.急性高原病诊断和预测因素的研究进展[J].临床检验杂志,2014,3(4):717-723.
[8]孔繁一,刘诗翔,张皓,等.脑内谷氨酸和羟色胺增高是高原睡眠障碍的独立预测因素[J].疑难病杂志,2013,12(11):843-846.
[9]郝丽娟,任雨青,谢军,等.西宁地区不同方法治疗睡眠呼吸暂停低通气综合征的效果观察[J].高原医学杂志,2009,19(4):25-28.
[10]吴天一,李素芝,李文翔.玉树地震灾后重建工人中高原头痛及与高原睡眠关系的研究[J].中国医药科学,2014,4(18):7-10.