成年打鼾人群患阻塞性睡眠呼吸暂停的危险因素分析

doi:10.19438/j.cjoms.2024.02.004

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (2): 137-142.doi: 10.19438/j.cjoms.2024.02.004

成年打鼾人群患阻塞性睡眠呼吸暂停的危险因素分析

郑彤^*, 姚侃^*, 钱轶峰, 孙红霞, 卢晓峰^#, 于雯雯^#

上海交通大学医学院附属第九人民医院口腔颅颌面科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海 200011

收稿日期:2023-06-26 修回日期:2023-08-07 出版日期:2024-02-20 发布日期:2024-03-27
通讯作者: 卢晓峰,E-mail: lukeluxf@163.com;于雯雯,E-mail: ywwyww2015@126.com。^#共同通信作者
作者简介:郑彤（1995-）,女,硕士,E-mail: yoyo51228@sina.com;姚侃（1990-）,男,硕士,E-mail: discant@163.com。^*并列第一作者
基金资助:
国家自然科学基金青年项目（81800992）

Risk factors for obstructive sleep apnea in snoring adults

ZHENG Tong^*, YAO Kan^*, QIAN Yi-feng, SUN Hong-xia, LU Xiao-feng^#, YU Wen-wen^#

Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011, China

Received:2023-06-26 Revised:2023-08-07 Online:2024-02-20 Published:2024-03-27

摘要/Abstract

摘要： 目的: 探索成年打鼾人群罹患阻塞性睡眠呼吸暂停的相关危险因素,尝试性提出新型预测工具。方法: 采用横断面研究,对2012年1月—2021年10月于上海交通大学医学院附属第九人民医院睡眠医学中心进行整夜多导睡眠监测(polysomnography, PSG)的成年打鼾人群进行数据收集,依据睡眠呼吸暂停低通气指数(apnea hyponea index, AHI)进行阻塞性睡眠呼吸暂停(obstructive sleep apnea, OSA)患病与否分组,分为非OSA组与OSA组,对成年打鼾人群OSA患病危险因素进行分析。结果: 纳入研究对象1 155例,整体OSA患病率为88.23%,患者男女比例为4.12∶1。成年打鼾人群罹患OSA的危险因素是年龄、颈围/身高比、性别、腰围,相应预警值为30.5岁、22.93、男性、86.25 cm。对于成年打鼾人群,提出OSA预测工具WRAG-N,预测OSA的AUC为0.789,灵敏度为87.2%,特异度为29.4%。结论对于成年打鼾人群,30岁以上、男性、腰围大于86.25cm是OSA患病的危险因素,颈围/身高比是OSA患病与否的关键危险因素之一。作为罹患OSA的新型预测工具,WRAG-N有助于基层社区筛查成年打鼾高危人群,及时进行预防及诊治。

关键词: 成人, 打鼾, 阻塞性睡眠呼吸暂停, 危险因素

Abstract: PURPOSE: To explore the risk factors for obstructive sleep apnea in snoring adults. METHODS: A cross-sectional study was conducted in 1 155 adult snoring patients who were overnight polysomnography(PSG) monitored for obstructive sleep apnea(OSA) from January 2012 to October 2021 in Sleep Medicine Center of Shanghai Ninth People's Hospital. The patients were divided into two groups based on apnea hypopnea index (AHI): non-OSA and OSA groups. The prevalence and risk factors of OSA were analyzed. RESULTS: The prevalence of OSA was 88.23%, and the male to female ratio was 4.12∶1. The risk factors for OSA in snoring adults were age, neck circumference/height ratio, gender and waist circumference, of which the thresholds were 30.5 years old, 22.93, male, 86.25 cm. WRAG-N was proposed to predict OSA, with an AUC of 0.789, a sensitivity of 87.2%, and a specificity of 29.4%. CONCLUSIONS: For adult snoring population, the risk factors for OSA were over 30 years old, male and waist circumference greater than 86.25 cm. Meanwhile, neck circumference/height ratio is one of the key risk factors for OSA. WRAG-N, innovatively proposed as the predictive tool for OSA, may help communities screen OSA in high-risk snoring adults to provide efficient and high-quality diagnosis and treatment.

Key words: Adult, Snoring, Obstructive sleep apnea, Risk factors

中图分类号:

R782.2

郑彤, 姚侃, 钱轶峰, 孙红霞, 卢晓峰, 于雯雯. 成年打鼾人群患阻塞性睡眠呼吸暂停的危险因素分析[J]. 中国口腔颌面外科杂志, 2024, 22(2): 137-142.

ZHENG Tong, YAO Kan, QIAN Yi-feng, SUN Hong-xia, LU Xiao-feng, YU Wen-wen. Risk factors for obstructive sleep apnea in snoring adults[J]. China J Oral Maxillofac Surg, 2024, 22(2): 137-142.

参考文献

[1] Gami AS, Olson EJ, Shen WK, et al.Obstructive sleep apnea and the risk of sudden cardiac death: a longitudinal study of 10 701 adults[J]. J Am Coll Cardiol, 2013, 62(7): 610-616.
[2] Koh H, Van Vliet S, Cao C, et al.Effect of obstructive sleep apnea on glucose metabolism[J]. Eur J Endocrinol, 2022, 186(4): 457-467.
[3] Schütz S, Lisabeth L, Gibbs R, et al.Ten-year trends in sleep-disordered breathing after ischemic stroke: 2010 to 2019 data from the basic project[J]. J Am Heart Assoc, 2022, 11(4): e024169.
[4] Zhang MM, Ma Y, Du LT, et al.Sleep disorders and non-sleep circadian disorders predict depression: a systematic review and meta-analysis of longitudinal studies[J]. Neurosci Biobehav Rev, 2022, 134: 104532.
[5] 郑成竹, 李际辉. 中国肥胖病外科治疗指南(2007)[J]. 中国实用外科杂志, 2007, 27(10): 759-762.
Zheng CZ, Li JH.Guidelines for surgical treatment of obesity in China (2007)[J]. Chinese Journal of Practical Surgery, 2007, 27(10): 759-762.
[6] Pevernagie D, Gnidovec-strazisar B, Grote L, et al. On the rise and fall of the apnea-hypopnea index: a historical review and critical appraisal[J]. J Sleep Res, 2020, 29(4): e13066.
[7] Carná Z, Osmancík P.The effect of obesity, hypertension, diabetes mellitus, alcohol, and sleep apnea on the risk of atrial fibrillation[J]. Physiol Res, 2021, 70(Suppl 4): S511-S525.
[8] US Preventive Services Task Force, Mangione CM, Barry MJ, et al. Screening for obstructive sleep apnea in adults: US Preventive Services Task Force recommendation statement[J]. JAMA, 2022, 328(19): 1945-1950.
[9] 上海市医学会呼吸病学分会睡眠呼吸疾病学组. 上海市30岁以上人群阻塞性睡眠呼吸暂停低通气综合征流行病学调查[J]. 中华结核和呼吸杂志, 2003, 26(5): 268-272.
Sleep Respiratory Diseases Group, Respiratory Society of Shanghai Medical Association. An epidemiological survey of obstructive sleep apnea hypopnea syndrome in people over 30 years old in Shanghai[J]. Chinese Journal of Tuberculosis and Respiratory, 2003, 26(5): 268-272.
[10] 苏小凤, 刘霖, 仲琳, 等. 中国阻塞性睡眠呼吸暂停综合征患病率的Meta分析[J]. 中国循证医学杂志, 2021, 21(10): 1187-1194.
Su XF, Liu L, Zhong L, et al.Prevalence of obstructive sleep apnea syndrome in China: a meta-analysis[J]. Chinese Journal of Evidence-based Medicine, 2021, 21(10): 1187-1194.
[11] 中华医学会, 中华医学会杂志社, 中华医学会全科医学分会, 等. 成人阻塞性睡眠呼吸暂停基层诊疗指南(实践版·2018)[J]. 中华全科医师杂志, 2019, 18(1): 30-35.
Chinese Medical Association, Journal of Chinese Medical Association, General Medicine Branch of Chinese Medical Association, et al. Primary diagnosis and treatment guidelines for adults with obstructive sleep apnea (Practice Edition, 2018)[J]. Chinese Journal of General Practitioners, 2019, 18(1): 30-35.
[12] Narang I, Al-saleh S, Amin R, et al. Utility of neck, height, and tonsillar size to screen for obstructive sleep apnea among obese youth[J]. Otolaryngol Head Neck Surg, 2018, 158(4): 745-751.
[13] Cervantes-theurel J, Albarran-sanchez A, Rodriguez-perez V, et al. Utility of the STOP-Bang and Epworth scales and the neck-to-height ratio to detect severe obstructive apnea-hypopnea syndrome in severe obesity[J]. Surg Obes Relat Dis, 2021, 17(2): 257-262.
[14] Lee SD, Ju G, Choi JA, et al.The association of oxidative stress with central obesity in obstructive sleep apnea[J]. Sleep Breath, 2012, 16(2): 511-517.
[15] Davidson TM, Patel MR.Waist circumference and sleep disordered breathing[J]. Laryngoscope, 2008, 118(2): 339-347.
[16] 中国肥胖问题工作组数据汇总分析协作组. 我国成人体重指数和腰围对相关疾病危险因素异常的预测价值:适宜体重指数和腰围切点的研究[J]. 中华流行病学杂志, 2002, 23(1): 10-15.
China Obesity Working Group Data Summary and Analysis Cooperation Group. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population[J]. Chinese Journal of Epidemiology, 2002, 23(1): 10-15.
[17] Johns M.Reliability and factor analysis of the Epworth Sleepiness Scale[J]. Sleep, 1992, 15(4): 376-381.
[18] Liamsombut S, Kaw R, Wang L, et al.Predictive value of sleep apnea screenings in cardiac surgery patients[J]. Sleep Med, 2021, 84: 20-25.
[19] Zheng Z, Sun X, Chen R, et al.Comparison of six assessment tools to screen for obstructive sleep apnea in patients with hypertension[J]. Clin Cardiol, 2021, 44(11): 1526-1534.
[20] He S, Li Y, Xu W, et al.Using clinical data to predict obstructive sleep apnea[J]. J Thorac Dis, 2022, 14(2): 227-237.
[21] Chung F, Abdullah H, Liao P.STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea[J]. Chest, 2016, 149(3): 631-638.
[22] Xiong M, Hu W, Dong M, et al.The screening value of ESS, SACS, BQ, and SBQ on obstructive sleep apnea in patients with chronic obstructive pulmonary disease[J]. Int J Chron Obstruct Pulmon Dis, 2019, 14: 2497-2505.
[23] Pataka A, Zarogoulidis P, Hohenforst-schmidt W, et al. During economic crisis can sleep questionnaires improve the value of oximetry for assessing sleep apnea?[J]. Ann Transl Med, 2016, 4(22): 443-453.
[24] de Menezes Júnior LAA, Fajardo VC, do Nascimento Neto RM, et al. Diagnostic accuracy of the Berlin questionnaire and the NoSAS score in detecting risk for obstructive sleep apnea in rotating shift workers[J]. Sleep Breath, 2022, 26(2): 743-751.
[25] Delesie M, Knaepen L, Hendrickx B, et al.The value of screening questionnaires/scoring scales for obstructive sleep apnea in patients with atrial fibrillation[J]. Arch Cardiovasc Dis, 2021,114(11): 737-747.
[26] Chen H, Zheng Z, Chen R, et al.A meta-analysis of the diagnostic value of NoSAS in patients with sleep apnea syndrome[J]. Sleep Breath, 2022, 26(2): 519-531.

成年打鼾人群患阻塞性睡眠呼吸暂停的危险因素分析

Risk factors for obstructive sleep apnea in snoring adults

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

本文评价

[1]	洪磊, 陈伟良. 口腔癌老年患者术后静脉血栓栓塞症的危险因素分析[J]. 中国口腔颌面外科杂志, 2024, 22(3): 233-238.
[2]	张银银, 朱岩岩, 丁嘉慧, 孙玉华. 144例口腔颌面部间隙感染并发症及入ICU监护的危险因素分析[J]. 中国口腔颌面外科杂志, 2024, 22(2): 148-152.
[3]	范晶娴, 吴嘉骏, 葛奎, 徐兵, 王齐, 杨天页, 王繁麟. 口腔颌面间隙感染患者全麻术后机械通气时间延长的危险因素分析[J]. 中国口腔颌面外科杂志, 2024, 22(2): 158-164.
[4]	王家慧, 段晓雯, 周徐慧, 仇琳, 李静洁, 蔡美华, 郑永超. 儿童阻塞性睡眠呼吸暂停综合征全麻苏醒期躁动风险预测模型的构建与验证[J]. 中国口腔颌面外科杂志, 2024, 22(2): 175-180.
[5]	王钰, 王明一, 侯黎莉, 向富萍, 梁家青, 赵小妹. 口腔颌面部恶性肿瘤患者手术部位感染危险因素的meta分析[J]. 中国口腔颌面外科杂志, 2023, 21(6): 603-609.
[6]	陈玉, 陶明, 雷银富, 吴和梅, 彭晓峰, 苟登群. 口腔癌患者术后肺部感染危险因素的meta分析[J]. 中国口腔颌面外科杂志, 2023, 21(5): 511-517.
[7]	李萍, 罗涛, 黄灿, 周驰, 孙宇. 口腔颌面-头颈恶性肿瘤术后急性肾损伤的发生率及危险因素分析[J]. 中国口腔颌面外科杂志, 2023, 21(4): 384-389.
[8]	向富萍, 侯黎莉, 杨玲, 王钰, 梁家青. 头颈部肿瘤患者术后发生谵妄危险因素的meta分析[J]. 中国口腔颌面外科杂志, 2023, 21(4): 407-412.
[9]	沈梦圆, 张雪莹, 赵姗, 徐欣晨, 李晓东, 孟箭. 头颈癌游离皮瓣患者术后谵妄危险因素及NLR的临床价值分析[J]. 中国口腔颌面外科杂志, 2023, 21(2): 131-136.
[10]	冯婉晴, 李静洁, 刘锦星, 劳蔚. 儿童阻塞性睡眠呼吸暂停综合征手术苏醒期疼痛危险因素分析[J]. 中国口腔颌面外科杂志, 2023, 21(2): 175-179.
[11]	施金雅, 李静洁, 刘锦星, 仇琳. 阻塞性睡眠呼吸暂停综合征患儿全麻术后拔管时间的影响因素分析[J]. 中国口腔颌面外科杂志, 2023, 21(2): 180-185.
[12]	王博, 于洪波, 夏韫晖, 房兵, 郭秋曼. 牙槽骨再生正畸技术治疗成人错畸形伴原发性牙槽骨缺损的远期疗效评价[J]. 中国口腔颌面外科杂志, 2022, 20(3): 225-229.
[13]	高志彪, 王磊, 肖霞, 高朵朵. 3种不同手术入路治疗成人髁突骨折效果分析[J]. 中国口腔颌面外科杂志, 2022, 20(2): 184-187.
[14]	赵欣然, 蔡鸣. 不同咽成形术式对腭裂术后继发腭咽闭合功能不全合并睡眠呼吸障碍的影响[J]. 中国口腔颌面外科杂志, 2021, 19(1): 76-81.
[15]	李晓东, 孟箭, 张凌, 叶为民. 238例头颈肿瘤患者重建术后谵妄危险因素分析[J]. 中国口腔颌面外科杂志, 2020, 18(3): 226-230.