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Title: [Follow-up study on natural course changes of obstructive sleep apnea hypopnea syndrome among young and middle aged patients].
Author: Zhang YY, Ren R, Li TM, Tan L, Zhang Y, Zhou JY, Lei F, Yang LH, Tang XD.
Journal: Zhonghua Yi Xue Za Zhi; 2019 Nov 12; 99(42):3323-3327. PubMed ID: 31715669.
Abstract:
Objective: To explore the natural course of obstructive sleep apnea-hypopnea syndrome (OSAHS) and its associated factors in young and middle-aged patients with OSAHS. Methods: A total of 52 young and middle-aged OSAHS patients were recruited in this study from West China Hospital of Sichuan University. All patients were performed twice overnight polysomnography (PSG) examinations. At the baseline, patients underwent the first PSG and clinical evaluation from September 2009 to September 2017 and the patients received the second PSG from January 2017 to January 2019. During the follow-up period, these patients had no treatment. All patients were categorized into two groups including mild-to-moderate [5/h≤ apnea-hypopnea index (AHI)<30/h] group and severe (AHI ≥ 30/h) group according to the baseline AHI value. Differences in the clinical characteristics and PSG variables between baseline and follow-up were compared in two groups separately using t-tests or Mann-Whitney U test. The general linear correlation analysis was used to explore the factors related to the severity of OSAHS including AHI, the mean oxyhemoglobin saturation and the minimal oxyhemoglobin saturation during the follow-up period. Results: This study recruited 28 OSAHS patients in mild-to-moderate group [mean age, (39.7±10.2) y] and 24 patients in severe group [mean age, (41.0±7.1) y]. Compared to the baseline, there was a significant increase in AHI value [(45.0±25.3) vs (33.6±27.3)/h, P<0.001] in all OSAHS patients. Notably, the increase of AHI was more significant in the mild-to-moderate OSAHS group [(32.1±22.2) vs (13.6±8.7)/h, P<0.05] but not in severe OSAHS patients [(60.7±19.5) vs (58.0±21.5)/h, P>0.05]. A person correlation analysis revealed that the AHI value was positively related to the age (r=0.531, P=0.004) in mild-to-moderate OSAHS patients. Conclusion: The severity of OSAHS is increased with the age in young and middle-aged patients with mild-to-moderate OSAHS, but not in those with severe OSAHS. 目的： 探讨中青年不同严重程度的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者的自然病程及影响因素。 方法： 回顾性分析四川大学华西医院睡眠医学中心以打鼾为主诉进行2次整夜多导睡眠监测（PSG）的52例中青年OSAHS患者的临床资料。以第1次监测（2009年9月至2017年9月）时的PSG结果及临床资料作为基线，随访时（2017年1月至2019年1月）进行第2次PSG，患者随访期间未接受任何治疗者纳入本研究。根据基线呼吸暂停低通气指数（AHI）分为轻中度组、重度组。比较两组患者基线和随访时一般临床资料和PSG参数，运用一般线性相关分析OSAHS严重程度[AHI、平均血氧饱和度（SpO₂）、最低SpO₂]的影响因素。 结果： 共纳入患者52例，其中轻中度组28例，基线年龄（39.7±10.2）岁；重度组24例，基线年龄（41.0±7.1）岁。与基线相比，随访时OSAHS患者AHI显著增加[（45.0±25.3）比（33.6±27.3）次/h，P<0.001]，但以轻中度组AHI增加明显[（32.1±22.2）比（13.6±8.7）次/h，P<0.05）]，重度组AHI变化不显著[（60.7±19.5）比（58.0±21.5）次/h，P>0.05]。Pearson相关分析发现，轻中度组AHI改变量与年龄改变量呈正相关（r=0.531，P=0.004）。 结论： 在中青年OSAHS患者中，轻中度患者的严重程度随年龄增长而加重，而重度患者无此明显改变。.

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