摘要
目的 分析十年间上海交通大学医学院附属第六人民医院阻塞性睡眠呼吸暂停(OSA)诊治中心初诊受试者的人口学、人体测量学、OSA严重程度及常见合并症等临床特征变化,以期为OSA诊治策略制定提供参考。方法 采集2012年1月~2021年12月间因疑患OSA于中心完成多导睡眠监测(PSG)的初诊受试者资料。以两年为一组将受试者分为5组,逐组分析临床特征变化趋势,着重比较2020~2021年与2018~2019年差异,探索新冠疫情开始后受试者的特征变化。结果 (1)2012~2019年间共纳入5 870例受试者,年龄(43.2±12.7)岁,女性占比21.7%,OSA患病率为84.8%。以两年为一组,逐组分析发现受试者年龄、女性占比、OSA严重程度等指标无显著趋势变化。中位体重指数(26.8 kg/m^(2)~26.0 kg/m^(2))及超重率(78.1%~73.4%)逐年降低,吸烟(38.1%~27.8%)及饮酒者占比(13.5%~6.4%)也呈降低趋势。常见合并症方面,受试者高血压患病率逐年升高(40.3%~51.8%),知晓率逐步降低(70.3%~59.4%);糖尿病患病率相对平稳(9.4%~9.7%),知晓率有所提高(49.5%~66.2%);血脂异常患病率均高(76.7%~78.3%),知晓率持续低位(20.8%~28.7%)。(2)2020~2021年间共纳入受试者805例,与2018~2019年相比女性占比降低(14.9%vs.22.0%),OSA严重程度增加(呼吸暂停低通气指数40.4次/h vs.29.2次/h);高血压、糖尿病及血脂异常的患病率(47.1%、6.9%、62.1%)及知晓率(52.4%、57.7%、17.8%)均较2018~2019年降低。(3)与知晓合并症者相比,不知晓者的收缩压(141 mmHg vs.134 mmHg)、舒张压(93 mmHg vs.85mmHg)、空腹血糖(7.87 mmol/L vs.6.07 mmol/L)及低密度脂蛋白(3.08 mmol/L vs.2.91 mmol/L)水平更高,上述趋势及差异比较均有统计学意义(P均<0.05)。结论 十年间PSG受试者的临床特征呈现年轻化、低女性占比、合并症减少、但OSA病情更重的趋势,且合并症知晓率有待提升,提示围绕OSA患者开展多学科诊治的重要性。
OBJECTIVE Aimed to analyze the demographic,anthropometric,severity,and common comorbidities of individuals with suspected obstructive sleep apnea(OSA) referred to the OSA diagnosis and treatment center of the Sixth People's Hospital affiliated with Shanghai Jiao Tong University School of Medicine from 2012 to 2021.METHODS Data of subjects with suspected OSA who underwent polysomnography(PSG) from January 2012 to December 2021 were collected.Subjects were categorized into five groups based on the PSG study date with a two-year interval.Clinical characteristics trends were compared across groups,focusing on the comparison between 2020-2021 and 2018-2019 to explore changes after COVID-19 epidemic.RESULTS 1.A total of 5870 subjects were included from 2012 to 2019[age(43.2±12.7)years,21.7% females].OSA prevalence was 84.8%.Over the two-year intervals,age,female proportion,OSA severity,and other indicators showed no significant changes.Body mass index(median 26.8kg/m2 to 26.0kg/m2) and overweight rates(78.1% to 73.4%) decreased yearly,as did the proportions of subjects who smoked(38.1% to 27.8%) and consumed alcohol(13.5% to 6.4%).The prevalence of hypertension increased yearly(40.3% to 51.8%),while awareness rates gradually decreased(70.3%to 59.4%).Diabetes prevalence remained relatively stable(9.4% to 9.7%),with increased awareness(49.5% to 66.2%).Dyslipidemia prevalence remained high(76.7% to 78.3%),with low awareness rates(20.8% to 28.7%).2.A total of 805 subjects were included from 2020 to 2021.Compared with 2018-2019,the proportion of females decreased(14.9% vs.22.0%),and OSA severity increased(apnea-hypopnea index 40.4 times/h vs.29.2 times/h).Prevalence rates of hypertension,diabetes,dyslipidemia(47.1%,6.9%,62.1%) and awareness rates(52.4%,57.7%,17.8%) were lower than those from 2018-2019.3.Compared with subjects with known their comorbidities,unknown subjects had significantly higher levels of systolic blood pressure(141 mmHg vs.134 mmHg),diastolic blood pressure(93 mmHg vs.85 mmHg),fasting blood glucose(7.87 mmol/L vs.6.07 mmol/L),and low-density lipoprotein(3.08 mmol/L vs.2.91 mmol/L)(P<0.05).CONCLUSION From 2012 to 2021,individuals with suspected OSA referred for PSG test showed a tendency toward younger age,lower proportion of females,fewer comorbidities,but increased OSA severity.The awareness rate of comorbidities needs improvement,emphasizing the importance of a multidisciplinary approach to the diagnosis and treatment of OSA.
作者
杨佳鑫
刘玉璞
孟丽丽
许华俊
朱华明
关建
易红良
胡三莲
殷善开
YANG Jiaxin;LIU Yupu;MENG Lili;XU Huajun;ZHU Huaming;GUAN Jian;YI Hongliang;HU Sanlian;YIN Shankai(Department of Otolaryngology Head and Neck Surgery,the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200233,China;Shanghai Key Laboratory of Sleep Respiratory Disorders,Shanghai,200233,China;Institute of Otolaryngology Head and Neck Surgery,Shanghai Jiao Tong University,Shanghai,200233,China;Department of Nursing,the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200233,China)
出处
《中国耳鼻咽喉头颈外科》
CSCD
2023年第12期794-799,共6页
Chinese Archives of Otolaryngology-Head and Neck Surgery
基金
国家自然科学基金(82101205、81770987)
上海市科学技术委员会科技创新行动计划(18DZ2260200)
上海申康医院发展中心临床三年行动计划(SHDC2020CR2044B、SHDC2020CR3056B)
上海市第六人民医院探索类临床研究(YNTS202205)。
作者简介
第一作者/通信:杨佳鑫,女,河南人,护理学硕士,护士,主要从事阻塞性睡眠呼吸暂停慢病的管理Email:835221192@qq.com;通信作者:刘玉璞,Email:sunrisingup@163.com。
