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目的:探讨睡眠呼吸暂停综合征(SAS)患者红细胞压积与夜间低氧血症的相关性。方法:对290例有夜间打鼾伴超重的男性患者进行夜间持续7小时多导睡眠监测。监测项目包括:夜间最低氧饱和度、夜间平均氧饱和度、氧饱和度低于90%所累计的时间(TST90%)、体位;于次日晨空腹抽取静脉血进行血细胞计数测定。SAS 定义为睡眠呼吸暂停低通气指数(AHI)≥5次/h,AHI<5次/h 作为对照组(30例),分析夜间血氧指标与红细胞压积的相关性。结果:①SAS 患者年龄、体重指数、AHI 和 TST90%显著高于对照组(P<0.05～0.001),夜间最低氧饱和度、夜间平均氧饱和度则显著低于对照绀(P<0.001);SAS 轻-中度组(AHI 5～30,132例)和 SAS 重度组(AHI>30,128例)与对照组比较血细胞各参数水平均无统计学差异(P 均>0.05)。②调整年龄、体重指数、基础疾病、收缩压、舒张压和血脂等多个因素后,SAS 患者的红细胞压积仍与夜间最低氧饱和度呈显著负相关,而与 AHI 呈显著正相关。结论:SAS 患者红细胞压积升高与夜间最低氧饱和度和 AHI 有相关性。
Objective: To investigate the relationship between hematocrit and nocturnal hypoxemia in patients with sleep apnea syndrome (SAS). Methods: A total of 290 men with nocturnal snoring and overweight were monitored for polysomnography for 7 hours at night. Monitoring items include nighttime lowest oxygen saturation, nighttime average oxygen saturation, oxygen saturation less than 90% of the cumulative time (TST90%), body position; the next morning, fasting venous blood samples were taken for determination of blood count. SAS was defined as sleep apnea hypopnea index (AHI) ≥5 beats / h and AHI <5 beats / h as control group (n = 30). The correlation between nocturnal oximetry and hematocrit was analyzed. Results: The age, body mass index, AHI and TST90% of SAS patients were significantly higher than those of the control group (P <0.05-0.001). The lowest nighttime oxygen saturation and nighttime mean oxygen saturation were significantly lower than those of the control subjects (P <0.001) There was no significant difference in all parameters of blood cells between mild-moderate group (AHI 5 ~ 30,132) and SAS severe group (AHI> 30,128) (all P> 0.05). ② After adjusting for factors such as age, body mass index, underlying diseases, systolic blood pressure, diastolic blood pressure and blood lipids, the hematocrit in patients with SAS remained negatively correlated with the lowest oxygen saturation at night and positively correlated with AHI. CONCLUSIONS: The elevated hematocrit in SAS patients correlates with nocturnal oxygen saturation and AHI.