阻塞性睡眠呼吸暂停低通气综合征患者鼾声响度与颈动脉内膜斑块形成的相关性分析

目的探讨阻塞性睡眠呼吸暂停低通气综合征患者鼾声响度与颈动脉内膜斑块形成的关系。方法选取2015年1月—2017年8月在河北医科大学第一医院耳鼻喉科确诊的阻塞性睡眠呼吸暂停低通气综合征患者97例,均进行多导睡眠监测(PSG)和/或Watch-PAT检测,根据患者鼾声的响度将其分为轻度鼾声组(≤35 dB)、中度鼾声组(35~55 dB)、重度鼾声组(≥55 dB)。同时选取同期健康查体者68例作为健康对照组(排除阻塞性睡眠呼吸暂停低通气综合征以及发作性睡病、中枢性睡眠呼吸暂停低通气综合征等睡眠相关疾病)。记录4组受试者一般资料及颈动脉彩超检查结果,采用Logistic回归分析鼾声响度与颈动脉斑块形成的关系。结果轻度鼾声组28例,中度鼾声组34例,重度鼾声组35例。健康对照组颈动脉斑块检出率为17.6%(12/68),轻度鼾声组、中度鼾声组、重度鼾声组颈动脉斑块检出率分别为39.3%(11/28)、61.8%(21/34)、82.9%(29/35),各鼾声组颈动脉斑块检出率明显高于健康对照组,且重度鼾声组高于中度鼾声组,中度鼾声组高于轻度鼾声组,差异均有统计学意义(P均<0.05)。Logistic回归分析显示,中、重度打鼾为颈动脉斑块的危险因素,其OR(95%CI)分别为5.216(2.387,18.652)和22.371(3.598,131.230)。结论中、重度打鼾与颈动脉斑块检出率有关,鼾声的响度越大,阻塞性睡眠呼吸暂停低通气综合征患者发生颈动脉斑块的风险越高。

Correlation analysis between snoring loudness and carotid plaque formation in patients with obstructive sleep apnea hypopnea syndrome

Objective It is to detect the correlation between snoring loudness and carotid plaque formation in patients with obstructive sleep apnea hypopnea syndrome.Methods A total of 97 patients with obstructive sleep apnea-hypopnea syndrome diagnosed in the department of otorhinolaryngology of the First Hospital of Hebei Medical University from January 2015 to August 2017 were selected and detected by polysomnography(PSG)and/or Watch-PAT.According to the loudness of the snoring these patients were divided into mild snoring group(≤35 dB),moderate snoring group(35-55 dB),severe snoring group(≥55 dB).At the same time,68 healthy subjects were selected as healthy control group(excluding obstructive sleep apnea hypopnea syndrome and sleep-related diseases such as narcolepsy and central sleep apnea hypopnea syndrome).The general information and carotid color Doppler ultrasound examination results of the subjects in the 4 groups were recorded,and the relationship between snoring loudness and carotid plaque formation was analyzed by Logistic regression.Results There were 28 cases in the mild snoring group,34 cases in the moderate snoring group,and 35 cases in the severe snoring group.The detection rate of carotid plaque in healthy control group was 17.6%(12/68),and the detection rate of carotid plaque in mild snoring group,moderate snoring group and severe snoring group were 39.3%(11/28)and 61.8%(21/34),82.9%(29/35),respectively,the detection rate of carotid plaque in each snoring group was significantly higher than that in the healthy control group,and the severe snoring group was higher than the moderate snoring group,and the moderate snoring group was higher than the mild group,the differences were all significant(all P<0.05).Logistic regression analysis showed that moderate and severe snoring was a risk factor for carotid plaque,and their OR(95%CI)were 5.216(2.387,18.652)and 22.371(3.598,131.230),respectively.Conclusion Moderate and severe snoring is related to the detection rate of carotid plaque.The louder the snoring,the higher the risk of carotid plaque in patients with obstructive sleep apnea hypopnea syndrome.