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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(jià)及意義魯建光，韓晶，王超（哈爾濱醫(yī)科大學(xué)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(fù)》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(jīng)常出現(xiàn)白天嗜睡，其程度與病情密切相關(guān)。本研究探討OSAHS患者白天嗜睡程度的評價(jià)方法及其臨床意義。方法:疑似OSAHS的患者65例，行多導(dǎo)睡眠圖（polysomnography，PSG）檢查，符合OSAHS診斷標(biāo)準(zhǔn)者57例，納入本研究，其余8例作為對照組（非
2、OSAHS組）。排除標(biāo)準(zhǔn)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(jīng)系統(tǒng)興奮性藥物病史者。OSAHS組57例，根據(jù)PSG結(jié)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(jìn)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(guān)性。結(jié)果:ESS評分與呼吸紊亂指數(shù)（apnea-hypopneaindex,AHI）呈正相關(guān)(r=0.81，P<0.01)；與睡眠中最低血氧飽和度（SpO2）呈負(fù)相關(guān)(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(jié)論:ESS是評價(jià)OSAHS患者白天嗜睡程度的較好指標(biāo)，ESS評分對于OSAHS的輕重程度有明顯的預(yù)測價(jià)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(shù)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
