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目的探讨 Epworth 嗜睡量表(Epworth sleepiness scale,ESS)评价阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)病情严重程度的价值。方法分析总结2000年1月至2003年12月4年间登记资料完整的620例疑似 OSAHS 成人患者的多道睡眠监测仪(polysomnography,PSG)监测结果。男556例,女64例;年龄21～79岁,中位数45.0岁;身高147～178 cm,中位数172.0 cm;体重50～130 kg,中位数82.0 kg;体重指数18.5～42.9,中位数28.0;呼吸暂停低通气指数(apnea-hypopnea index,AHI)0～126.1次/h,中位数37.2次/h;最低血氧饱和度(lowest arterial oxygen saturation,LAST)0.21～0.93,中位数0.75;Epworth 嗜睡分值(ESS)0～24,中位数13.0。符合 OSAHS 者513例,单纯鼾症107例。比较 ESS 与 AHI 和 LSAT 的关系,并进行统计学处理。结果 Pearson 相关分析发现,ESS 与 OSAHS 患者的 AHI 及 LSAT 的相关系数分别为0.314和-0.312,尽管统计学检验 P<0.05,但相关性很低。单纯鼾症以及轻、中度 OSAHS 各组间 ESS 中位数值差异无统计学意义(P>0.05);重度 OSAHS 组 ESS 中位数值为14.0,高于单纯鼾症以及轻、中度OSAHS 组(分别为10.0、10.0和11.5),P<0.05。按最低血氧饱和度为依据划分低氧血症各组,发现无低氧血症组以及轻、中度低氧血症各组间 ESS 中位数值差异无统计学意义(P>0.05),重度低氧血症组 ESS 中位数值为16.0,高于无低氧血症组以及轻、中度低氧血症组(分别为10.0、12.0和11.0),P<0.05。结论 ESS 作为评估 OSAHS 病情严重程度的指标的价值不大,需要研究制定适合中国人的评定 OSAHS 患者的嗜睡评分标准。
Objective To investigate the value of Epworth sleepiness scale (ESS) in evaluating the severity of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods The results of polysomnography (PSG) monitoring of 620 adults with suspected OSAHS who had complete registration data from January 2000 to December 2003 were analyzed. 556 males and 64 females; aged 21-79 years old, with a median of 45.0 years old; height 147-178 cm, median 172.0 cm; weight 50-130 kg, median 82.0 kg; body mass index 18.5-42.9, The median was 28.0; the apnea-hypopnea index (AHI) ranged from 0 to 126.1 times / h with a median of 37.2 times / h; the lowest arterial oxygen saturation (LAST) Median 0.75; Epworth Sleepiness Score (ESS) 0-24, median 13.0. 513 patients with OSAHS, simple snoring in 107 cases. The relationship between ESS and AHI and LSAT was compared and statistically analyzed. Results Pearson correlation analysis found that the correlation coefficient between AHI and LSAT in patients with ESS and OSAHS were 0.314 and -0.312, respectively, although the statistical test P <0.05, but the correlation was low. There was no significant difference in ESS between simple snoring and moderate and severe OSAHS groups (P> 0.05). The median value of ESS in severe OSAHS group was 14.0, higher than those in simple snoring group and mild to moderate OSAHS group 10.0, 10.0 and 11.5, respectively), P <0.05. According to the lowest oxygen saturation, each group of hypoxemia was divided into two groups: no hypoxemia group and mild to moderate hypoxemia group ESS median value was not statistically significant (P> 0.05) The median ESS of patients with severe hypoxemia was 16.0, which was significantly higher than that of patients without hypoxemia and with mild or moderate hypoxemia (10.0,12.0 and 11.0, respectively) (P <0.05). Conclusion The value of ESS as an index for assessing the severity of OSAHS is not significant, and it is necessary to study the criteria for developing a somnolence assessment for OSAHS patients suitable for Chinese.