【摘要】： OSAHS是睡眠呼吸障礙的最常見形式,其特點是睡眠時反復(fù)發(fā)生上氣道塌陷導(dǎo)致經(jīng)常覺醒,間歇低氧,睡眠片段化和睡眠質(zhì)量下降。流行病學(xué)調(diào)查顯示OSAHS的發(fā)病率較高,在我國其發(fā)病率是12%-13%�，F(xiàn)普遍認(rèn)為OSAHS是一種全身性疾病,所有導(dǎo)致鼻腔、咽腔和喉腔任何部位狹窄的原因都可以成為OSAHS的致病因素。OSAHS患者睡眠時反復(fù)發(fā)生上氣道塌陷導(dǎo)致慢性間歇低氧,睡眠片段化,從而引起機體分子信號域的變化,如交感神經(jīng)活性增強,氧化應(yīng)激和炎癥等,加重或?qū)е禄颊叱霈F(xiàn)白天嗜睡、腦卒中、高血壓、冠狀動脈粥樣硬化性心臟病、心律失常、心力衰竭、肺動脈高壓、支氣管哮喘、胃食管反流、蛋白尿、糖尿病及胰島素抵抗等全身多系統(tǒng)損傷,影響個人的生活和生命質(zhì)量,給個人和社會帶來沉重的經(jīng)濟負(fù)擔(dān)。OSAHS的診斷“金標(biāo)準(zhǔn)”是PSG,除PSG外,便攜式家庭用睡眠呼吸監(jiān)測儀、上氣道及食管壓力測定、上氣道三維影像學(xué)CT或MRI等其他多種監(jiān)測技術(shù)可用于OSAHS的篩查和協(xié)助診斷。臨床OSAHS的診斷主要依據(jù)病史和PSG監(jiān)測結(jié)果,其診斷標(biāo)準(zhǔn)是7h睡眠中,呼吸暫停和低通氣超過30次,或AHI5。對OSAHS患者進行積極的治療,可以預(yù)防嚴(yán)重影響人體健康并發(fā)癥的發(fā)生,改善治療效果、提高生活質(zhì)量、提前評估預(yù)后。多年來CPAP已成為OSAHS的首選治療方法。不論發(fā)病機制如何,只要病人能夠接受,CPAP均可治療。
[Abstract]:OSAHS is the most common form of sleep apnea, characterized by recurrent upper airway collapse during sleep resulting in frequent arousal, intermittent hypoxia, sleep fragmentation and sleep quality decline. Epidemiological investigation shows that the incidence of OSAHS is high, and in our country, the incidence is 12-13. It is widely believed that OSAHS is a systemic disease. All the causes of narrow nasal, pharyngeal and laryngeal lumen can be the pathogenic factors of OSAHS. The recurrent collapse of upper airway in patients with OSAHS leads to chronic intermittent hypoxia and sleep fragmentation. Thus causing changes in molecular signal domains, such as increased sympathetic activity, oxidative stress and inflammation, exacerbating or leading to daytime sleepiness, stroke, hypertension, coronary atherosclerotic heart disease, arrhythmia, etc. Heart failure, pulmonary hypertension, bronchial asthma, gastroesophageal reflux, proteinuria, diabetes, insulin resistance, and other systemic multisystem injuries affect individual life and quality of life. The golden standard for the diagnosis of OSAHS is PSG. In addition to PSG, portable household sleep breathing monitors, upper airway and esophageal pressure measurements are used. Many other monitoring techniques, such as CT or MRI, can be used for screening and diagnosis of OSAHS. The diagnosis of clinical OSAHS is mainly based on the history and the results of PSG monitoring. The diagnostic criteria are more than 30 times of apnea and hypopnea or AHI 5 during 7 h sleep. The active treatment of OSAHS patients can prevent the occurrence of serious complications affecting human health, improve the therapeutic effect, improve the quality of life, and evaluate the prognosis ahead of time. Over the years, CPAP has become the preferred treatment for OSAHS. No matter what the pathogenesis, as long as the patient can accept CPAP can be treated.
【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2010
【分類號】：R766

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4 李，

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