本文關(guān)鍵詞： 白天嗜睡 Epworth評分量表 白天多次小睡潛伏實驗 平均入睡潛伏期 阻塞性睡眠呼吸暫停低通氣綜合癥　出處：《蘇州大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：通過對OSAHS患者進行Epworth評分以及MSLT檢測,探討ESS、MSLT在評價OSAHS患者白天嗜睡及輔助診斷中的價值。 方式：選取2007年08月至2010年12月因打鼾至我院睡眠中心行多導(dǎo)睡眠監(jiān)測(polysomnography, PSG)的患者83例,平均年齡(54.81士14.19)歲,體塊指數(shù)(body mass index, BMI) (25.83±4.22)kg/m2,其中男性63例,女性20例,對上述患者,分別進行Epworth評分及白天多次小睡潛伏實驗(MSLT)。根據(jù)AHI值將其分為單純鼾癥組(AHI5,n=23), OSAHS輕中度組(5≤AHI≤40,n=22), OSAHS重度組(AHI40,n=38),采用獨立樣本T檢驗比較各組ESS、MSL、睡眠結(jié)構(gòu)參數(shù)及低氧參數(shù)的差異,其中睡眠結(jié)構(gòu)參數(shù)包括：睡眠潛伏期、總睡眠時間、睡眠效率、1期睡眠比例、2期睡眠比例、慢波睡眠比例、REM睡眠比例、REM睡眠潛伏期及微覺醒指數(shù),低氧參數(shù)包括氧減指數(shù)、最低血氧飽和度、AHI；用非參數(shù)相關(guān)法分析ESS及MSL與上述PSG參數(shù)之間的相關(guān)性；用偏相關(guān)法分析MSL與ESS的相關(guān)性,同時以MSL10min為金標(biāo)準(zhǔn)診斷白天嗜睡,評價Epworth量表對OSAHS患者白天嗜睡的診斷價值。并進一步將患者根據(jù)MSL分為正常組(MSL≥10min,n=39),輕中度嗜睡組(5min≤MSL10min,n= 32),重度嗜睡組(MSL5min,n=12),比較三組間ESS評分的差異。以AHI≥5為診斷OSAHS標(biāo)準(zhǔn),評價Epworth量表篩選OSAHS的價值。 結(jié)果：1.輕中度OSAHS組MSL(10.98±5.18min)較單純鼾癥組(14.09±3.43 min)顯著減少(P0.05),重度OSAHS組MSL(6.83±3.12min)較輕中度組縮短(P0.05)。ESS各組之間均無明顯統(tǒng)計學(xué)意義。2.MSL與夜間PSG監(jiān)測參數(shù)中睡眠結(jié)構(gòu)(睡眠潛伏期、總睡眠時間、睡眠效率、2期睡眠比例、慢波睡眠比例、REM睡眠比例、REM睡眠潛伏期、微覺醒指數(shù))具有相關(guān)性(P0.01,或0.05),與低氧參數(shù)(最低血氧飽和度、氧減指數(shù)、AHI)具有相關(guān)性(P0.01,或0.05)；而在上述參數(shù)中,ESS與慢波睡眠比例、REM潛伏期、REM期比例無相關(guān)性。3.排除年齡、體重指數(shù)因素,MSL與ESS間有顯著負(fù)相關(guān)性(r=-0.369,P0.01),以MSL10min為金標(biāo)準(zhǔn)判斷OSAHS患者白天嗜睡,ESS診斷白天嗜睡的ROC曲線下面積為0.762。不同嗜睡程度組之間比較,ESS評分呈逐漸增高趨勢,重度嗜睡組ESS評分(17.58±3.99)較正常組(8.36±5.84)明顯增高(P0.05)。以AHI5為OSAHS診斷標(biāo)準(zhǔn),ESS篩選OSAHS的曲線下面積為0.775。 結(jié)論：MSLT與ESS相比,更能準(zhǔn)確反映OSAHS患者的日間嗜睡程度,且隨著OSAHS嚴(yán)重程度的增加,患者嗜睡傾向加重；ESS可用于評價OSAHS患者白天嗜睡情況,對OSAHS有一定初篩作用,但誤診率偏高。
[Abstract]:Objective: to evaluate the value of Epworth score and MSLT in the evaluation of daytime sleepiness and auxiliary diagnosis of OSAHS patients. Methods: from August 2007 to December 2010, 83 patients with polysomnography (PSG) underwent polysomnography from snoring to sleep center of our hospital. The mean age was 54.81 鹵14.19) years. The body mass index (BMI) was 25.83 鹵4.22 kg / m2, including 63 males and 20 females. According to the AHI value, the patients were divided into simple snoring group, OSAHS mild to moderate group, OSAHS mild and moderate group, and OSAHS severe group. The differences of ESS MSLs, sleep structure parameters and hypoxic parameters were compared by independent sample T test. Among them, sleep structure parameters include: sleep latency, total sleep time, sleep efficiency, sleep rate, REM sleep latency and microarousal index, and hypoxia parameters include oxygen reduction index, REM sleep latency and microarousal index, slow wave sleep ratio and REM sleep ratio. The correlation between ESS and MSL and the above-mentioned PSG parameters was analyzed by non-parametric correlation method, the correlation between MSL and ESS was analyzed by partial correlation method, and the daytime sleepiness was diagnosed by using MSL10min as the gold standard. To evaluate the diagnostic value of Epworth scale for daytime somnolence in OSAHS patients, and to further divide the patients into three groups according to MSL: normal group, mild to moderate somnolence group, 5 minutes 鈮，

本文編號：1534228