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1、阻塞性睡眠呼吸暫停低通氣綜合征患者白天嗜睡程度的評價及意義魯建光，韓晶，王超（哈爾濱醫(yī)科大學附屬第二醫(yī)院耳鼻咽喉科，哈爾濱，150086）本文發(fā)表于《中國臨床康復》2004年第36期摘要目的:阻塞性睡眠呼吸暫停低通氣綜合征（ObstructiveSleepApnea-HypopneaSyndrome，OSAHS）患者經常出現(xiàn)白天嗜睡，其程度與病情密切相關。本研究探討OSAHS患者白天嗜睡程度的評價方法及其臨床意義。方法:疑似OSAHS的患者65例，行多導睡眠圖（polysomnography，PSG）檢查，符合OSAHS診斷標準者57例，納入本研究，其余8例作為對照組（非
2、OSAHS組）。排除標準為有頭部創(chuàng)傷、癲癇、腦腫瘤、腦出血、代謝中毒、感染等病史，以及服用影響神經系統(tǒng)興奮性藥物病史者。OSAHS組57例，根據(jù)PSG結果分為輕度組（15例）、中度組（9例）和重度組（33例）3組。采用Epowrth嗜睡評估表(Epworthsleepinessscale,ESS)對所有65例患者進行測評，比較非OSAHS組及不同程度OSAHS組ESS評分的差異及其與疾病程度的相關性。結果:ESS評分與呼吸紊亂指數(shù)（apnea-hypopneaindex,AHI）呈正相關(r=0.81，P<0.01)；與睡眠中最低血氧飽和度（SpO2）呈負相關(r=－0.
3、62，P<0.01)；OSAHS組ESS評分顯著高于非OSAHS組（t=2.82，P<0.01）；重度OSAHS組ESS評分顯著高于中度組，中度OSAHS組ESS評分顯著高于輕度組，3組之間ESS評分差異有非常顯著性意義(F=19.19，P<0.01)；結論:ESS是評價OSAHS患者白天嗜睡程度的較好指標，ESS評分對于OSAHS的輕重程度有明顯的預測價值。主題詞:睡眠呼吸暫停，阻塞性；過度嗜睡性障礙；多道睡眠描記術TheevaluationofdaytimesleepinessanditsmeaninginpatientswithObstructiveSleepApn
4、ea-HypopneaSyndromeJian-guangLu,JingHan,ChaoWang,DepartmentofOtorhinolaryngology,TheSecondAffiliatedHospitalofHarbinMedicalUniversity,Harbin150086,ChinaAbstractObjective:ThepatientswhowiththeOSAHSoftenappeardaytimesleepiness.Itsdegreeispertinenttothestateofanillness.Thedisquisitioninvesti
5、gatetheevaluationmethodofdaytimesleepinessanditsmeaninginpatientswithOSAHS.Methods:65patientswhoseemtobeillwithOSAHShadbeeninspectedwiththePSG，57casesofthesepatientsaccordedthediagnosisstandardofOSAHS,theywerebroughtintotheinvestigation.Theothers8caseswerebroughtintotheantithesesgroup.The
6、standardofremovecomprisethepatientswhowithskullwound,fallingsickness,encephalontumor,encephalonbleeding,poisoning,infectandtake6medicineofcenternervesystem.The57patientswhobroughtintotheOSAHSgroupwereseparatedinto3groups,low-grade(15cases),middle-grade(9cases)andserious-grade(33cases).All
7、ofthese65patientshadbeenevaluatedwiththeESS.ThedifferenceofESSbetweenthepatientswithandwithoutOSAHSwascompared.TheESSdifferenceinOSAHSpatientswithdifferentdegreewascomparedatthesametime.Results:TherearepluspertinencesbetweenESSandAHI(r=0.81，P<0.01)andminuspertinence
