摘要目的 调查职业驾驶员阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的患病率及与交通事故的关系.方法 对2014年10月至2015年9月在上海市嘉定区中心医院进行年度健康体检的950名职业驾驶员,给予OSAHS相关的问卷调查.对中、重度打鼾和(或)Epworth嗜睡量表(ESS)评分≥9分的驾驶员进行家庭睡眠监测,依据调查及监测结果将受试者分为OSAHS组和非OSAHS组.比较两组间驾龄、颈围、体质指数(BMI)、平均夜间睡眠时间;ESS评分≥9分、高血压、糖尿病及扁桃体肥大患者的比例以及交通事故的发生率.采用多元Logistic回归分析交通事故的危险因素.结果 回收合格问卷826份(87.0％),报告打鼾者578例(70.0％),剔除因血氧饱和度探头脱落的3名,最终823名纳人分析.OSAHS组111例(13.5％),其中轻、中、重度分别有47、38及26例;非OSAHS组712名.OSAHS组的颈围、BMI及ESS评分≥9分、高血压、糖尿病、扁桃体肥大患者比例均显著高于非OSAHS组[(39.8±3.8)比(39.0±3.0) cm、(26.7±4.2)比(24.4±3.8) kg/m2及57.7％比12.6％、27.9％比5.9％、4.5％比1.1％、7.2％比2.3％](均P＜0.05);而驾龄、平均夜间睡眠时间差异均无统计学意义(均P＞O.05).一年内总体交通事故发生率为5.8％ (48/823),其中OSAHS组显著高于非OSAHS组[17.1％(19/111)比4.1％ (29/712)] (P＜ 0.001).嗜睡(OR=30.578,95％ CI:10.699～87.394;P＜0.001)、OSAHS(OR=14.062,95％ CI:4.791 ～ 41.269;P＜0.001)、车龄(OR=2.345,95％ CI:1.183～4.646;P＜0.05)为交通事故的危险因素;而平均夜间睡眠时间(OR=0.037,95％ CI:0.014～0.098;P＜0.001)为其保护性因素.结论 职业驾驶员OSAHS的患病率较高,有OSAHS者发生交通事故的可能性明显增大.

abstractsObjective To study the prevalence of obstructive sleep apnea hypopnea syndrome (OSAHS) and its relationship with traffic accidents in the professional drivers.Methods Questionnaires of OSAHS were sent to 950 professional drivers who had annual physical examination at the Central Hospital of Jiading District in Shanghai from October 2014 to September 2015.Those with moderate to severe snoring and/or Epworth Sleepiness Scale (ESS) ≥9 performed the home sleep testing.All drivers were divided into OSAHS and non-OSAHS according to the survey and monitoring.The following parameters were compared such as driving ages,neck circumference,body mass index (BMI),average night sleep time,ESS,hypertension,diabetes,hypertrophy of tonsil and the incidence of traffic accidents.The risk factors of traffic accidents were analyzed by multivariate Logistic regression.Results Totally 826 responses were eligible,including 578 (70.0％) with self-reported snoring.There was measurement failure involving 3 of 233 the home sleep testing due to sensor off,823 subjects were included in the study.The prevalence of OSAHS was 13.5％ (111/823).The mild,moderate and severe OSAHS were 47,38 and 26 cases respectively.There were 712 drives without OSAHS.The neck circumference [(39.8 ± 3.8) vs (39.0 ± 3.0) cm] and BMI [(26.7 ± 4.2) vs (24.4 ± 3.8) kg/m2] were significantly higher in the drivers suffering from OSAHS (all P ＜0.05).The percentage of ESS≥ 9 (57.7％ vs 12.6％),hypertension (27.9％ vs 5.9％),diabetes (4.5％ vs 1.1％),hypertrophy of tonsil (7.2％ vs 2.3％) were higher in the drivers with OSAHS (all P ＜0.05).There were no significant difference in driving ages and average night sleep time between two groups (all P ＞ 0.05).The overall incidence of traffic accidents was 5.8％ (48/823) in a year.The percentage was respectively 17.1％ (19/111) in OSAHS and 4.1％ (29/712) in non-OSAHS (P＜ O.001).Multiple logistic regression analysis showed that sleepiness (OR =30.578,95％ CI:10.699-87.394;P ＜ 0.001),OSAHS (OR =14.062,95％ CI:4.791-41.269;P ＜ 0.001) and vehicle years (OR =2.345,95％ CI:1.183-4.646;P ＜ 0.05)were the risk factors,while the average night sleep time (OR=0.037,95％CI:0.014-0.098;P＜0.001) was the protective factor.Conclusion Professional drivers have higher prevalence of OSAHS,which contributes to the increased risk of traffic accidents.