本文關(guān)鍵詞： 肥胖低通氣綜合征 阻塞性睡眠呼吸暫停低通氣綜合征 臨床特點　出處：《石河子大學》2016年碩士論文　論文類型：學位論文

【摘要】：目的探討肥胖低通氣綜合征(OHS)和阻塞性睡眠呼吸暫停低通氣綜合征(OSAHS)患者的臨床特點方面異同,為臨床工作中正確鑒別兩病提供依據(jù)。方法應用病例對照研究為研究方法,選取2010-2015年新疆維吾爾自治區(qū)人民醫(yī)院收住院治療的OHS患者35例、OSAHS患者45例,進行兩組間臨床資料的收集、歸納、統(tǒng)計學計算及分析。結(jié)果OHS組與OSAHS組年齡和性別比例差異無統(tǒng)計學意義(P0.05)。OHS組35人,有吸煙史者28人,OSAHS組45人,有吸煙史者35人,經(jīng)四格表資料卡方檢驗,P0.05,差異無統(tǒng)計學意義。兩組的BMI、頸圍、腰圍用均數(shù)±標準差(±s)的形式表示分別為35.6±4.8、50.6±7.2、113±10.1,29.3±4.2、37±2.1、98.2±8.1,經(jīng)t檢驗進行組間比較,差異具有統(tǒng)計學意義(P0.05)。OHS組患者比OSAHS組患者更易發(fā)生白天嗜睡,本研究發(fā)現(xiàn)OHS組患者ESS評分平均值更高,兩組此指標的差異具有統(tǒng)計學意義,OHS組患者相比OSAHS組患者記憶力減退、晨間頭痛、下肢水腫、晨起口干、夜間睡眠憋醒這些臨床癥狀更常見,兩組差異有統(tǒng)計學意義(P0.05)。夜尿增多差異無統(tǒng)計學意義。兩組的日間清醒狀態(tài)的Pa O2、Pa CO2,PSG監(jiān)測的最低血氧飽和度、平均血氧飽和度、氧飽和度90%時間、呼吸暫停低通氣指數(shù)(AHI)、低通氣平均持續(xù)時間差異有統(tǒng)計學意義(P0.05)。睡眠呼吸暫停持續(xù)時間差異無統(tǒng)計學意義(P0.05)。OSAHS組患者的肺功能檢測結(jié)果提示,FEV1、FVC、FEV1/FVC、MVV、VC一般在正常范圍,OHS組患者的FEV1、FVC、MVV、VC、FEV1/FEV1pred這些指標一般都有降低,與OSAHS組進行比較差異具有統(tǒng)計學意義,兩組的FEV1/FVC都一般在正常范圍,差異不具有統(tǒng)計學意義。OHS組與OSAHS組比較,OHS組合并高血壓、冠心病、認知障礙、腦血管疾病、II型呼吸衰竭的病例數(shù)更多,且差異有統(tǒng)計學意義(P0.05)。結(jié)論OHS患者與OSAHS患者相比:肥胖程度更重,發(fā)生臨床癥狀機率及種類更多且程度更重,肺功能多表現(xiàn)為限制性通氣功能障礙,睡眠監(jiān)測提示缺氧程度會更重且持續(xù)時間一般更長,發(fā)生并發(fā)癥的機率更多。
[Abstract]:Objective to explore the differences and similarities of the clinical characteristics between the patients with obesity hypopnea syndrome (OHS) and obstructive sleep apnea hypopnea syndrome (OSAHS), and to provide evidence for the correct differentiation of the two diseases in clinical work. From 2010 to 2015, 35 OHS patients who were hospitalized in Xinjiang Uygur Autonomous region people's Hospital were selected to collect the clinical data between the two groups. Results there was no significant difference in age and sex ratio between OHS group and OSAHS group. There was no significant difference between the two groups in terms of BMI, neck circumference and waist circumference (鹵s) in the form of mean 鹵standard deviation (鹵s), which were respectively 35.6 鹵4.80.63 鹵7.2C, 113 鹵10.1C, 29.3 鹵4.2U, 37 鹵2.1 鹵98.2 鹵8.1, and were compared between the two groups by t-test. The difference was statistically significant (P 0.05). OHS group was more prone to daytime sleepiness than OSAHS group. This study found that the average value of ESS score in OHS group was higher than that in OSAHS group. The difference between the two groups was statistically significant. Clinical symptoms such as morning headache, edema of the lower extremities, dry mouth in the morning and sleep at night are more common. There was significant difference between the two groups (P 0.05). There was no significant difference in nocturnal urine. The lowest oxygen saturation, mean oxygen saturation and oxygen saturation 90% time were monitored by Pao _ 2O _ 2 CO _ 2P _ 2P _ 2P _ (2) G in daytime awake state of the two groups, and no significant difference in nocturnal urine was found between the two groups. Apnea hypopnea index (AHI) and mean duration of hypopnea were significantly different (P 0.05). There was no significant difference in sleep apnea duration (P 0.05). The results of pulmonary function test in patients with OSAHS suggested that FEV1 / FVCV 1 / FVC1 / MVVV VC was generally in normal range of OHS group. Patients' FEV1 / FEV1 / FEV1 / FEV1pred were generally reduced. The difference between OHS group and OSAHS group was statistically significant. The FEV1/FVC of the two groups were in normal range, but the difference was not statistically significant. OHS group was compared with OSAHS group in combination with hypertension, coronary heart disease, cognitive impairment, and no significant difference was found between OHS group and OSAHS group. The number of patients with type II respiratory failure of cerebrovascular disease was more, and the difference was statistically significant (P 0.05). Conclusion compared with OSAHS patients, OHS patients are more obese, have more clinical symptoms, and have more kinds of clinical symptoms. Pulmonary function is usually characterized by restricted ventilation dysfunction. Sleep monitoring indicates that hypoxia is more severe and lasts longer and complications are more likely.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R766;R589.2

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