Epworth嗜睡量表联合微动敏感床垫式睡眠监测系统对荆门市东宝区成年女性打鼾及阻塞性睡眠呼吸暂停低通气综合征流行病学调查
|
摘要
目的了解荆门市东宝区18岁以上女性居民打鼾及睡眠呼吸暂停低通气综合征(OSAHS)发病率和危险因素,为该病的防治提供依据。方法采用整群抽样法和Epworth嗜睡量表,对荆门市东宝区东方百货集团18岁以上女性职工及女性家属进行打鼾问卷调查,计算人群中打鼾发病率、分析其危险因素。数据表随机抽取60例打鼾人群应用微动敏感床垫式睡眠监测系统(micro-movement sensitive mattress sleep monitoring system,MSMSMS)进行整夜睡眠呼吸监测,推算人群中OSAHS的患病率。结果共发放调查表2028份,收回有效问卷1961份,有效率为96.70%。打鼾735人,发病率为37.48%,随年龄增加,打鼾、发病率逐渐增加,50~59岁达高峰。体重指数超标者打鼾及OSAHS的发病率增高。打鼾患者容易引起心脑血管疾病。根据症状、体征,按睡眠呼吸暂停低通气指数(AHI)≥5次/h为诊断标准,在抽取的60例打鼾患者中共确诊48例OSAHS,推算人群患病人数518例,发病率为26.42%(518/1961)。Epworth嗜睡量表与MSMSMS符合率80.00%,其中轻度OSAHS二者诊断符合率12例,符合率60.00%,中、重度OSAHS,二者诊断符合率各18例,符合率90.00%。结论荆门市东宝区成年女性打鼾及阻塞性睡眠呼吸暂停低通气综合征发病率较高,打鼾人群心脑血管系统疾病的发生率明显高于非打鼾人群。应根据其流行病学特点制定相应的防治策略,降低OSAHS及其并发症的发生率。ESS联合MSMSMS具有很好的诊断中、重度OSAHS的应用价值,可在临床推广应用。
Objective To understand the prevalence and high risk factors of snoring,obstructive sleep apnea hypopnea syndrome(OSAHS)in adults female aged over 18 years in Dongbao District of Jingmen City. Methods The method of cluster sampling and Epworth sleepiness scale(ESS)were used. Female workers from Oriental department store in Dongbao District of Jingmen City and their Female family members aged over 18 years were investigated by questionnaires. The prevalence of snoring was calculated and risk factors were analyzed. 60 cases randomly selected by data table were monitored by micro-movement sensitive mattress sleep monitoring system,(MSMSMS),and the prevalence of OSAHS was estimated. Results A total of 2028 questionnaires were issued,and 1961 valid questionnaires were collected with the effective rate of 96.70%. There were 735 snorers,and the general prevalence was 37.48%. With age increasing,snoring and the disease incidence increased gradually and would reach the peak at 50~59 years old. The prevalence of snoring and OSAHS was higher in overweight patients. The snorers have higher incidence of cardiovascular and cerebrovascular diseases. According to the symptom and sign,AHI≥5 times/h was defined as the diagnostic standard,48 were diagnosed as having OSAHS among the 60 selected snorers. Based on this,518 people were calculated to suffer from OSAHS,and the prevalence was 26.42%(518/1961). The coincidence rate of the Epworth sleepiness scale and the MSMSMS was 80%. 12 cases were diagnosed with mild OSAHS by these two methods and the coincidence rate was 60%;while 18 cases were diagnosed with moderate and severe OSAHS,and the coincidence rate was 90%. Conclusion The incidence of snoring and OSAHS is higher among the adult aged over 18 years in Dongbao District of Jingmen City. People with snoring are more likely to suffer from cardiovascular diseases than the non-snoring group. Strategies and measures should be made to reduce the incidence of the disease and its complications according to the epidemiological characteristics. ESS combined with MSMSMS is a valuable measurement for the diagnosis of moderate and severe OSAHS patients and can be widely used in clinical practice.
Objective To understand the prevalence and high risk factors of snoring,obstructive sleep apnea hypopnea syndrome(OSAHS)in adults female aged over 18 years in Dongbao District of Jingmen City. Methods The method of cluster sampling and Epworth sleepiness scale(ESS)were used. Female workers from Oriental department store in Dongbao District of Jingmen City and their Female family members aged over 18 years were investigated by questionnaires. The prevalence of snoring was calculated and risk factors were analyzed. 60 cases randomly selected by data table were monitored by micro-movement sensitive mattress sleep monitoring system,(MSMSMS),and the prevalence of OSAHS was estimated. Results A total of 2028 questionnaires were issued,and 1961 valid questionnaires were collected with the effective rate of 96.70%. There were 735 snorers,and the general prevalence was 37.48%. With age increasing,snoring and the disease incidence increased gradually and would reach the peak at 50~59 years old. The prevalence of snoring and OSAHS was higher in overweight patients. The snorers have higher incidence of cardiovascular and cerebrovascular diseases. According to the symptom and sign,AHI≥5 times/h was defined as the diagnostic standard,48 were diagnosed as having OSAHS among the 60 selected snorers. Based on this,518 people were calculated to suffer from OSAHS,and the prevalence was 26.42%(518/1961). The coincidence rate of the Epworth sleepiness scale and the MSMSMS was 80%. 12 cases were diagnosed with mild OSAHS by these two methods and the coincidence rate was 60%;while 18 cases were diagnosed with moderate and severe OSAHS,and the coincidence rate was 90%. Conclusion The incidence of snoring and OSAHS is higher among the adult aged over 18 years in Dongbao District of Jingmen City. People with snoring are more likely to suffer from cardiovascular diseases than the non-snoring group. Strategies and measures should be made to reduce the incidence of the disease and its complications according to the epidemiological characteristics. ESS combined with MSMSMS is a valuable measurement for the diagnosis of moderate and severe OSAHS patients and can be widely used in clinical practice.
引文
1. 中华耳鼻咽喉科头颈外科杂志编辑委员会,中华医学会耳鼻咽喉科头颈外科分会咽喉学组.阻塞性睡眠呼吸暂停低通气综合征诊断和外科治疗指南.中华耳鼻咽喉头颈外科杂志,2009,44:95-96.
2. 张颖,王继华.OSAHS病因的研究进展.中国现代医药杂志,2010,12:120-122.
3. Young T,Palta M,Dempsey J,etal.The occurrence of sleepdisordered breathing among middle-aged adults.N Engl J Med,1993,328:1230-1235.
4. Ferini-Strambi L,Zucconi M,Castronovo V,etal.Snoring&sleep apnea a population study in Italian women.Sleep,1999,22:859-864.
5. Tufik S,Santos-Silva R,Taddei JA,et al.Obstructive sleep apnea syndrome in the Sao Paulo epidemiologic sleep study.Sleep Med,2010,11:441-446.
6. Ip MS,Lam B,Tang LC,etal.A community study of sleepdisordered breathing in middle-aged Chinese women in Hong Kong:prevalence and gender differences.Chest,2004,125:127-134.
7. 叶京英,王小轶,韩德民,等.中老年女性阻塞性睡眠呼吸暂停低通气综合征的社区调查.中华耳鼻咽喉头颈外科杂志,2005,40:611-617.
8. 刘建红,韦彩周,黄陆颖,等.广西地区打鼾及阻塞性性睡眠呼吸暂停低通气综合征的流行病学调查.中华流行病学杂志,2007,28:115-118.
9.高雪梅,赵颖,曾祥龙,等.北京地区鼾症和睡眠呼吸暂停综合征的流行病学研究.口腔正畸学,1997,4:162-165.
10. 亢丹,叶京英,张玉焕,等.微动敏感床垫式睡眠监测系统对阻塞性睡眠呼吸暂停低通气综合征诊断作用的研究.中国耳鼻咽喉头颈外科杂志,2011,18:403-406.
11. 罗芸,薛毅珑,杨军,等.微动敏感床垫应用于睡眠呼吸障碍和睡眠质量监测的回顾性分析.医学研究杂志,2011,40(4):59-62.
12. 许华俊,李庆云,蓝孝斐,等.不同严重度阻塞性睡眠呼吸暂停低通气综合征女性血压影响因素分析.内科理论与实践,2012,7:439-442.
13. 严治涛,张丽丽,韩瑞梅,等.高血压专科就诊患者阻塞性睡眠呼吸暂停低通气综合征的检出率调查.中华高血压杂志,2012,20:272-276.
14. 侯晓平,缪京莉,王玉军,等.老年心血管病患者睡眠呼吸障碍和周期性腿动的研究.实用老年医学,2010,24:209-212.
15. 张志勇,杨水珍,王翔,等.女性糖尿病患者鼾症、睡眠时长与心血管疾病标志物的相关性研究.疑难病杂志,2015,14:1030-1032.
2. 张颖,王继华.OSAHS病因的研究进展.中国现代医药杂志,2010,12:120-122.
3. Young T,Palta M,Dempsey J,etal.The occurrence of sleepdisordered breathing among middle-aged adults.N Engl J Med,1993,328:1230-1235.
4. Ferini-Strambi L,Zucconi M,Castronovo V,etal.Snoring&sleep apnea a population study in Italian women.Sleep,1999,22:859-864.
5. Tufik S,Santos-Silva R,Taddei JA,et al.Obstructive sleep apnea syndrome in the Sao Paulo epidemiologic sleep study.Sleep Med,2010,11:441-446.
6. Ip MS,Lam B,Tang LC,etal.A community study of sleepdisordered breathing in middle-aged Chinese women in Hong Kong:prevalence and gender differences.Chest,2004,125:127-134.
7. 叶京英,王小轶,韩德民,等.中老年女性阻塞性睡眠呼吸暂停低通气综合征的社区调查.中华耳鼻咽喉头颈外科杂志,2005,40:611-617.
8. 刘建红,韦彩周,黄陆颖,等.广西地区打鼾及阻塞性性睡眠呼吸暂停低通气综合征的流行病学调查.中华流行病学杂志,2007,28:115-118.
9.高雪梅,赵颖,曾祥龙,等.北京地区鼾症和睡眠呼吸暂停综合征的流行病学研究.口腔正畸学,1997,4:162-165.
10. 亢丹,叶京英,张玉焕,等.微动敏感床垫式睡眠监测系统对阻塞性睡眠呼吸暂停低通气综合征诊断作用的研究.中国耳鼻咽喉头颈外科杂志,2011,18:403-406.
11. 罗芸,薛毅珑,杨军,等.微动敏感床垫应用于睡眠呼吸障碍和睡眠质量监测的回顾性分析.医学研究杂志,2011,40(4):59-62.
12. 许华俊,李庆云,蓝孝斐,等.不同严重度阻塞性睡眠呼吸暂停低通气综合征女性血压影响因素分析.内科理论与实践,2012,7:439-442.
13. 严治涛,张丽丽,韩瑞梅,等.高血压专科就诊患者阻塞性睡眠呼吸暂停低通气综合征的检出率调查.中华高血压杂志,2012,20:272-276.
14. 侯晓平,缪京莉,王玉军,等.老年心血管病患者睡眠呼吸障碍和周期性腿动的研究.实用老年医学,2010,24:209-212.
15. 张志勇,杨水珍,王翔,等.女性糖尿病患者鼾症、睡眠时长与心血管疾病标志物的相关性研究.疑难病杂志,2015,14:1030-1032.