综述
ENGLISH ABSTRACT
整夜睡眠血氧饱和度低于90%时间占总监测时间的百分比与阻塞性睡眠呼吸暂停低通气常见合并症的关系
王乐
张静
王彦
呙恒娟
曹洁
陈宝元
作者及单位信息
·
DOI: 10.3760/cma.j.issn.1001-0939.2020.01.014
Relationship between T90% and common comorbidities in patients with obstructive sleep apnea hypopnea syndrome
Wang Le
Zhang Jing
Wang Yan
Guo Hengjuan
Cao Jie
Chen Baoyuan
Authors Info & Affiliations
Wang Le
Zhang Jing
Wang Yan
Guo Hengjuan
Cao Jie
Chen Baoyuan
·
DOI: 10.3760/cma.j.issn.1001-0939.2020.01.014
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摘要

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)是一种常见的睡眠呼吸疾病,其睡眠中发生的慢性间歇低氧(chronic intermittent hypoxia,CIH)常对全身多个系统造成损害。T90%是PSG数据中的常见指标,指整夜睡眠过程中血氧饱和度(SpO 2)<90%的时间占总监测时间的百分比,与呼吸暂停低通气指数(apnea hypopnea index, AHI)和最低血氧饱和度(minSpO 2)相比,能更准确、更直观地反映OSAHS患者整个睡眠期低氧的情况。多项研究表明T90%与OSAHS相关合并症密切相关。本文就T90%与OSAHS常见相关合并症的关系加以综述,有助于全面而准确地评估OSAHS患者病情的严重程度,对OSAHS合并症做到早期发现、早期诊断、早期治疗,降低合并症的风险、减少合并症的危害。

引用本文

王乐,张静,王彦,等. 整夜睡眠血氧饱和度低于90%时间占总监测时间的百分比与阻塞性睡眠呼吸暂停低通气常见合并症的关系[J]. 中华结核和呼吸杂志,2020,43(1):63-67.

DOI:10.3760/cma.j.issn.1001-0939.2020.01.014

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阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)是一种常见的睡眠呼吸紊乱疾病,其特点是睡眠过程中反复出现口鼻气流消失或明显减弱,并伴有日间嗜睡、疲乏无力等症状 [ 1 ]。国外一项时间跨度长达20年、资料来源于11项研究的分析结果显示,普通人群OSA发病率男性为22%(9%~37%)、女性为17%(4%~50%) [ 2 ]。我国的流行病学调查显示,OSAHS患者发病率为2%~4%,男性高于女性,且随年龄增长,发病率呈逐渐增高趋势 [ 3 ]。OSAHS患者睡眠状态下反复出现呼吸暂停和低通气,使机体处于慢性间歇低氧(chronic intermittent hypoxia,CIH)的特殊内环境,进而对全身多个系统造成损害。文献报道OSAHS可对人体心脑血管、神经、内分泌、泌尿生殖、消化、血液等多个系统造成损害 [ 4 ]。目前OSAHS的诊断和严重程度分级标准,以呼吸暂停低通气指数(apnea hypopnea index, AHI)和最低脉搏血氧饱和度(minSpO 2)为主要判读指标。但临床上经常遇到AHI与低氧血症程度严重分离的现象。一些患者AHI属于重度范围,但每次呼吸暂停不造成严重的低氧血症;而另一些患者AHI不高,但每次呼吸暂停的血氧饱和度都严重减低。可见AHI并不能完全反映OSAHS患者病情的严重程度。T90%是指整夜睡眠过程中血氧饱和度(SpO 2)<90%的时间占总监测时间的百分比,与AHI反映呼吸暂停和低通气的次数和minSpO 2反映某一时间点的血氧不同,其反映了OSAHS患者整夜睡眠过程中低氧的持续时间,能更准确、更直观地反映OSAHS患者整个睡眠期低氧的情况。目前没有统一的T90%分级标准,李进让等 [ 5 ]提出根据OSHAS患者的T90%可分为轻、中、重度缺氧,T90%为5%~10%时,划分为轻度缺氧,>10%≤25%为中度缺氧,>25%为重度缺氧。CIH是OSAHS患者继发合并症的核心机制之一,而T90%能够描述OSAHS患者整夜睡眠期低氧情况,所以越来越多研究开始关注T90%与OSAHS患者合并症的关系。
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曹洁,Email: mocdef.3ab61eijoacjt
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所有作者均声明不存在利益冲突
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国家自然科学基金 (81670084, 81600067)
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