摘要目的 通过分析眼睑松弛和阻塞性睡眠呼吸暂停综合征(OSAHS)各指标的关系,初步探讨眼睑松弛发生的病理生理基础.方法 福建医科大学附属第二医院呼吸科睡眠监测室于2006年10月至2007年3月期间行多导睡眠监测(PSG)并确诊为OSAHS的患者44例,行眼睑松弛度检查,记录年龄、性别、体重指数(BMI)、睡眠呼吸暂停低通气指数(AHI)、快速动眼期(REM)占睡眠时间的百分数、血氧饱和度(SaO2)＜90%的时间等参数.随机选择在我院体检中心做体检,无睡眠打鼾及睡眠质量问题,且既往无眼病史的正常人100名作为对照.OSAHS与正常对照组眼睑松弛发生率的比较采用卡方检验;OSAHS患者中眼睑松弛者与无眼睑松弛者相关指数的比较采用两独立样本t检验,眼睑松弛与A HI及BMI的相关性采用直线回归分析.结果 44例OSAHS患者中,眼睑松弛者27例(61%),高于正常对照组(7%)(x2=5.007,P＜0.01).OSAHS患者中,眼睑松弛者的AHI为(54.5±21.0)次/h,明显高于无眼睑松弛者(31.1±21.9)次/h(t=3.229,P=0.036);眼睑松弛者的BMI为(29.7±4.8)kg/m2,明显高于无眼睑松弛者(25.3±3.5)kg/m2(t=3.556,P=0.006).眼睑松弛与AHI及BMI成正相关(r=0.494、0.447,P＜0.05),而与REM及SaO2＜90%的时间等参数的相关性无统计学意义.结论 眼睑松弛多见于OSAHS患者,高的BMI和AHI是眼睑松弛的危险因素,提示肥胖和低通气可能是眼睑松弛产生和发展的原因.

abstractsObjective To analyze the parameters of floppy eyelid and obstructive sleep apnea-hypopnea syndrome (OSAHS) in order to discover the pathological basis of eyelid hyperlaxity.Methods Forty-four patients referred to the respiratory department of The Second Affiliated Hospital of Fujian Medical University and diagnosed with OSAHS were included in this study. Eyelid laxity and polysomnography parameters such as age, sex, body mass index (BMI), apnea and hypopnea index (AHI), percentage of REM during sleep, and time of SaO2＜90%, were recorded and analyzed.The control group consisted of 100 healthy people who underwent a routine physical checkup and did not have sleep disorder. Results In 44 patients who were found to have OSAHS, 27 patients (61%)were found to have floppy eyelid, which was higher than the control group (7%)(x2=5.007, P＜0.01).AHI in patients with floppy eyelid was (54.5±21.0)/h, which was higher than (31.1±21.9)/h in those without floppy eyelid (t=3.229, P=0.036). BMI in the floppy eyelid group was (29.7±4.8)kg/m2, which was higher than (25.3±3.5)kg/m2 in the non-floppy eyelid group (t=3.556, P=0.006). There was no difference in the percent of REM and time of SaO2＜90% in patients with or without floppy eyelid.AHI and BMI were correlated with floppy eyelid (r=0.494, 0.447, P＜0.05), but REM and SaO2＜90%were not correlated with floppy eyelid. Conclusion Floppy eyelid is common in OSAHS patients. High BMI and AHI are risk factors for floppy eyelid. The cause and development of eyelid hyperlaxity might be due to obesity and hypopnea.