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自动调节持续气道正压通气治疗阻塞性睡眠呼吸暂停低通气综合征患者依从性的影响因素
徐胜群,崔相国,丁晓旭,陈瑜,杨怀安*
0
(中国医科大学附属盛京医院睡眠医学中心, 沈阳 110020
*通信作者)
摘要:
目的 探讨自动调节持续气道正压通气(auto-CPAP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者依从性的相关影响因素。方法 回顾性分析2016年10月至2017年12月以睡眠打鼾症状就诊、经多导睡眠监测(PSG)检查确诊为OSAHS的患者102例,所有患者均接受auto-CPAP治疗。统计患者年龄、性别、体质量指数(BMI)、Epworth嗜睡量表(ESS)评分、鼻阻塞症状评估量表(NOSE)评分以及Mallampati评分。采用Kribbs标准将患者分为依从组和非依从组,采用χ2检验或两样本均数比较的t检验比较两组上述各项指标的差异,采用logistic回归模型分析影响OSAHS患者接受auto-CPAP治疗依从性的危险因素。结果 102例患者中男性89例、女性13例,年龄31~83(42.2±10.0)岁。65例(63.7%)患者治疗依从性好,归入依从组;37例(36.3%)治疗依从性差,归入非依从组。两组间ESS评分、NOSE评分、Mallampati评分差异均有统计学意义(P均<0.01),而年龄、性别、BMI差异无统计学意义(P均>0.05)。Logistic多因素回归分析结果显示,ESS评分(OR=1.183,95% CI 1.046~1.338;P=0.008)和Mallampati评分(OR=2.075,95% CI 1.121~3.839;P=0.020)是影响治疗依从性的独立危险因素。结论 ESS评分、NOSE评分和Mallampati评分可影响OSAHS患者对auto-CPAP治疗的依从性,其中ESS评分和Mallampati评分是影响患者治疗依丛性的独立危险因素。
关键词:  阻塞性睡眠呼吸暂停低通气综合征  持续气道正压通气  依从性
DOI:10.16781/j.0258-879x.2018.07.0808
投稿时间:2018-05-13修订日期:2018-07-04
基金项目:
Influencing factors of treatment compliance to automatic continuous positive airway pressure for obstructive sleep apnea-hypopnea syndrome
XU Sheng-qun,CUI Xiang-guo,DING Xiao-xu,CHEN Yu,YANG Huai-an*
(Department of Sleep Medical Center, Shengjing Hospital of China Medical University, Shenyang 110020, Liaoning, China
*Corresponding author)
Abstract:
Objective To explore the factors influencing patient compliance to automatic continuous positive airway pressure (auto-CPAP) treatment in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Retrospective analysis was done on 102 patients diagnosed as OSAHS by polysomnography (PSG), who were treated for sleep snoring symptoms between Oct. 2016 and Dec. 2017. All patients received auto-CPAP treatment. The age, gender, body mass index (BMI), Epworth sleepiness scale (ESS) score, nasal obstruction symptom evaluation (NOSE) score and Mallampati score were recorded and analyzed. The patients were divided into compliance group and non-compliance group by the Kribbs standard, and χ2 test and two sample t test were used to analyze the differences of the above indicators between the two groups. Logistic regression model was used to evaluate the risk factors of treatment compliance of OSAHS by auto-CPAP. Results The 102 patients, aged (42.2±10.0) years (ranging from 31 to 83 years), included 89 males and 13 females. Sixty-five (63.7%) patients had good compliance and were assigned to the compliance group, and 37 (36.3%) patients had poor compliance and were assigned to the non-compliance group. The ESS score, NOSE score and Mallampati score were significantly different between the two groups (all P<0.01), while the age, gender and BMI were not significantly different (all P>0.05). Logistic regression analysis showed that the ESS score (OR=1.183, 95% CI 1.046-1.338; P=0.008) and Mallampati score (OR=2.075, 95% CI 1.121-3.839; P=0.020) were independent risk factors of compliance. Conclusion ESS score, NOSE score, and Mallampati score are the influencing factors of treatment compliance to auto-CPAP in the OSAHS patients. ESS score and Mallampati score are the independent risk factors for treatment compliance.
Key words:  obstructive sleep apnea hypopnea syndrome  continuous positive air way pressure  compliance