【摘要】：目的:探討絕經(jīng)期女性阻塞性睡眠呼吸暫停的臨床特征,以及其相關(guān)風(fēng)險(xiǎn)因素。對(duì)象:收錄2014年1月至2017年1月就診于吉林大學(xué)第一臨床醫(yī)院呼吸內(nèi)科睡眠中心絕經(jīng)期女性患者,停經(jīng)一年以上,行多導(dǎo)睡眠監(jiān)測(cè),按照2011年阻塞性睡眠呼吸暫停診治指南,診斷為阻塞性睡眠呼吸暫停(Obstructive sleep apnea,OSA)患者,排除具有頜面部畸形,神經(jīng)肌肉疾病,以往進(jìn)行過鼾癥方面的手術(shù),以及接受持續(xù)氣道正壓通氣治療,有其他呼吸系統(tǒng)疾病史的患者。173名受試者入組,根據(jù)絕經(jīng)期時(shí)間,絕經(jīng)一年以上十年以下者為絕經(jīng)早期組,共87例,平均年齡(53.4±3.5)歲;絕經(jīng)十年以上者為絕經(jīng)晚期組,共86例,平均年齡(63.7±4.0)歲。方法:測(cè)量受試者身高、體重、頸圍、腹圍,應(yīng)用埃普沃思嗜睡量表(Epworth sleepiness scale,ESS)評(píng)價(jià)受試者嗜睡程度,多導(dǎo)睡眠監(jiān)測(cè)法檢測(cè)受試者睡眠呼吸暫停低通氣指數(shù)(Apnea-hypopnea index AHI)、低通氣指數(shù)(Hypopnea index,HI)占AHI的比率、夜間最低血氧飽和度、最長呼吸暫停時(shí)間,晨起檢測(cè)受試者收縮壓和舒張壓。進(jìn)一步分別在兩組受試者中進(jìn)行頸圍、腹圍以及收縮壓、舒張壓與AHI的相關(guān)分析。結(jié)果:與絕經(jīng)早期組相比,絕經(jīng)晚期組OSA受試者表現(xiàn)出嗜睡程度更高(p0.05)以及更高的AHI(p0.05),差別具有統(tǒng)計(jì)學(xué)意義;HI/AHI在絕經(jīng)早期組明顯高于絕經(jīng)晚期組(p0.001);夜間最低血氧飽和度在絕經(jīng)晚期組較絕經(jīng)早期組表現(xiàn)為更低(p0.05),兩組受試者最長呼吸暫停時(shí)間無統(tǒng)計(jì)學(xué)差異(p0.05)。腹圍和收縮壓在絕經(jīng)晚期組高于絕經(jīng)早期組(p0.05,p0.05);相關(guān)分析結(jié)果顯示,在絕經(jīng)期兩組患者,腹圍與AHI呈正相關(guān)(r=0.907,p0.001);收縮壓與AHI之間呈正相關(guān)(r=0.870,p0.001)。結(jié)論:1、絕經(jīng)期女性O(shè)SA嚴(yán)重程度隨絕經(jīng)期延長逐漸加重。2、肥胖是絕經(jīng)期女性O(shè)SA危險(xiǎn)因素之一。3、絕經(jīng)期女性O(shè)SA嚴(yán)重度增加高血壓發(fā)病的風(fēng)險(xiǎn)。
[Abstract]:Objective: to investigate the clinical features and risk factors of obstructive sleep apnea (OSAS) in menopausal women. Participants: from January 2014 to January 2017, postmenopausal female patients in the sleep center of Department of Apnea, the first Clinical Hospital of Jilin University, received polysomnography and polysomnography according to the guidelines for diagnosis and treatment of obstructive sleep apnea in 2011. Patients diagnosed with obstructive sleep apnea (Obstructive sleep apnea) were excluded from maxillofacial malformations, neuromuscular diseases, previous snoring operations, and continuous positive airway pressure ventilation. According to the period of menopause, 87 subjects with an average age of (53.4 鹵3.5) years, who had a history of other respiratory diseases, were in the early menopause group, and 86 patients had a postmenopausal period of more than ten years, according to the period of menopause, the average age was (53.4 鹵3.5) years. The average age was (63.7 鹵4.0) years. Methods: the height, weight, neck circumference, abdominal circumference of the subjects were measured. The degree of somnolence was evaluated by (Epworth sleepiness scale. The ratio of Apnea-hypopnea index AHI), hypopnea index (Hypopnea index HI) to AHI, nocturnal minimum oxygen saturation, longest apnea time, systolic and diastolic blood pressure were measured by polysomnography. The relationship between neck circumference, abdominal circumference, systolic blood pressure, diastolic blood pressure and AHI was further analyzed in both groups. Results: compared with the early menopausal group, The subjects of OSA in late menopausal group showed higher somnolence (p0. 05) and higher AHI (p0. 05), the difference was statistically significant (P 0. 001), and the nocturnal minimum oxygen saturation was higher in the early menopausal group than in the postmenopausal period group (p0. 001), and the nocturnal minimum oxygen saturation in the late menopausal group was higher than that in the postmenopausal group. There was no significant difference in the longest apnea time between the two groups (p0.05). The abdominal circumference and systolic blood pressure were higher in the late menopausal group than in the early menopausal group (p0.05), the results of correlation analysis showed that the abdominal circumference was positively correlated with AHI in the menopausal patients (r = 0.907 / p0.001), and the systolic blood pressure was positively correlated with AHI (r = 0.870 / p 0.001). Conclusion the severity of OSA in menopausal women increases with the prolongation of menopausal period. Obesity is one of the risk factors of OSA in menopausal women. The severity of OSA in menopausal women increases the risk of hypertension.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R766

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