关键词: 肥胖, 睡眠呼吸暂停, 阻塞性, 临床特征

Abstract: Background　Obesity is a common risk factor for obstructive sleep apnea-hypopnea syndrome （OSAHS）. The vast majority of patients with OSAHS are overweight or obese. Differences may exist in the clinical characteristics of OSAHS patients with different degrees of obesity. Objective　The clinical characteristics of OSAHS patients with different degrees of obesity were compared to determine the influence of different degrees of obesity on OSAHS. Methods　Patients with OSAHS diagnosed by polysomnography（PSG） in Sleep Medical Center of Xuzhou Medical University from January 2014 to September 2018 were selected as research subjects. The clinical data of patients were collected，including demographic data，clinical complications and major sleep parameters. According to the criteria of China Obesity Task Force，OSAHS patients were divided into three groups by their BMI，normal weight group（<24.0 kg/m2），overweight group（24.0-27.9 kg/m2），and obesity group（≥28.0 kg/m2）. The differences of clinical characteristics，comorbidities，and major sleep parameters were compared，and the correlation between BMI and major sleep parameters was analyzed. Results　A total of 1 586 OSAHS patients were included in the study，including 1 259（79.38%） males and 1 062（66.96%） smokers，and the average BMI was（28.20±4.19） kg/m2. Hypertension（44.89%，712/1 586），cerebrovascular disease（20.62%，327/1 586），and heart disease（13.55%，215
/1 586） were common complications of OSAHS. According to BMI，206 patients were in the normal weight group，616 were in the overweight group，and 764 were in the obesity group. There were significant differences in age，BMI，Epworth sleepiness scale（ESS） score，hypertension，diabetes，heart disease，cerebrovascular disease，oxygen desaturation index（ODI），apnoea–hypopnoea index（AHI），mean oxygen saturation（MSaO2），lowest oxygen saturation（LSaO2），and microarousal index among patients in three groups（P<0.05）. A further pairwise comparison showed that patients in overweight group had lower MSaO2 and LSaO2 than those in normal weight group（P<0.05），while their BMI，ODI，AHI and microarousal index were higher（P<0.05），and number of cases with cerebrovascular disease was higher（P<0.016 7）. The mean age of patients in obesity group was lower than those of patients in normal weight group（P<0.05），while the number of cases with cerebrovascular disease was higher（P<0.016 7）. MSaO2 and LSaO2 in the obesity group were lower than those in the normal weight group and overweight group（P<0.05），while the BMI，ESS score，ODI，AHI and microarousal index were higher（P<0.05），and number of cases with hypertension，diabetes，and heart disease were higher（P<0.016 7）. Pearson correlation analysis showed that BMI and AHI were linear positively correlated（r=0.312，P<0.001），MSaO2 and LSaO2 were linear negatively correlated （r=-0.501，-0.566； P<0.001）. Conclusion　The BMI of OSAHS patients is positively correlated with AHI. Obese and overweight OSAHS patients showed more severe syndromes and a higher rate of comorbidities. It shows that obesity may aggravate the severity of OSAHS.

Key words: Obesity；Sleep apnea, obstructive；Clinical features