阻塞性睡眠呼吸暂停综合征对非动脉炎性前部缺血性视神经病变的影响研究

Effect of obstructive sleep apnea syndrome on non-arteritic anterior ischemic optic neuropathy

  • 摘要:
    目的 探讨阻塞性睡眠呼吸暂停综合征(OSAS)对非动脉炎性前部缺血性视神经病变(NAION)的影响。
    方法 选取2021年1月—2022年12月前卫医院眼科诊治的55例NAION患者为研究对象, 均接受多导睡眠记录仪监测。记录患者呼吸暂停低通气指数(AHI)、夜间血氧饱和度(SaO2), 并测定患眼视网膜神经纤维层(RNFL)厚度,明确OSAS检出率。根据病情将患者分为轻度组、中度组和重度组,分析不同分级患者RNFL的差异。
    结果 55例NAION患者中,诊断为OSAS者42例(76.36%), 正常者13例(23.64%); OSAS患者中,轻度9例(21.43%), 中度15例(35.71%), 重度18例(42.86%); 各组患者的临床资料比较,差异无统计学意义(P>0.05)。不同OSAS分级患者的AHI、夜间最小SaO2、患眼RNFL厚度比较,差异有统计学意义(P < 0.05)。Spearman相关性分析表明, AHI、夜间最小SaO2与左眼、右眼RNFL厚度存在负相关性(P < 0.05), OSAS与NAION呈正相关(P < 0.05)。
    结论 OSAS对NAION会产生影响,且病情越重影响越大,可能是NAION潜在的干预因素。

     

    Abstract:
    Objective To explore the effect of obstructive sleep apnea syndrome (OSAS) on non-arteritic anterior ischemic optic neuropathy (NAION).
    Methods From January 2021 to December 2022, 55 patients with NAION diagnosed and treated in the Department of Ophthalmology of Qianwei Hospital were selected as research objects, and all of them were monitored by multi-channel sleep recorder. Patient's apnea hypopnea index (AHI) and nocturnal blood oxygen saturation (SaO2) were recorded, the thickness of the retinal nerve fiber layer (RNFL) in the affected eye was measured, and detection rate of OSAS was clarified. Patients were divided into mild group, moderate group and severe group according to their conditions of disease, and the differences of RNFL among patients with different grades were analyzed.
    Results Among the 55 NAION patients, 42 cases were diagnosed as OSAS (76.36%) and 13 cases were normal (23.64%); among the OSAS patients, there were 9 cases with mild degree (21.43%), 15 cases with moderate degree (35.71%), and 18 cases with severe degree (42.86%); there were no significant differences in the clinical materials between groups (P>0.05). There were significant differences in AHI, nocturnal minimum SaO2 and RNFL thickness among patients with different OSAS grades (P < 0.05). Spearman correlation analysis showed that there were negative correlations of AHI, nocturnal minimum SaO2 with RNFL thickness of the left and right eyes (P < 0.05), and OSAS was positively correlated with NAION (P < 0.05).
    Conclusion OSAS has an impact on NAION, and the more severe the condition is, the greater the impact will be, which may be a potential intervention factor for NAION.

     

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