Objective:To explore the characteristics of the sleep structures of patients with both chronic insomnia and obstructive sleep apnea (OSA) in plateau area.Methods:Polysomography Alice 5 was applied to 23 patients with primary chronic insomnia [insomnia group, age (48.2±9.9) years], 22 patients with both chronic insomnia and OSA [comorbidity group, age (46.8±8.9) years], who both came from Qinghai Red Cross Hospital between January, 2014 to June, 2015 and 20 subjects with normal sleep [healthy group, age (46.2±7.1) years] in plateau area (mainly in Xining, altitude 2 250 meters or above) to compare and explore their sleep structures by the whole night sleep monitoring in the sleep monitoring room. The sleep structures were compared according to the American Academy of Sleep Medicine (AASM) Manual for the Scoring of Sleep and Associated Events.Results:Compared to healthy group, insomnia group and comorbidity group both had significantly lower sleep efficiency [(62.4%±16.7%), (59.8%±16.0%) vs (80.9%±8.8%)], non-rapid eye movement (NREM) phase 2 sleep ratio [(37.9%±12.2%), (36.2%±12.5%) vs (49.7%±6.2%)] and rapid eye movement (REM) sleep ratio [(7.7%±4.0%), (6.5%±4.0%) vs (12.5%±4.6%)] (all P<0.05); comorbidity group had a significantly higher oxygen desaturation index than insomnia group and healthy group [(30.8±29.2) vs (7.9±7.5), (5.9±2.7) times/h] ( P<0.05); insomnia group′s sleep latency of NREM3 stage was significantly longer than comorbidity group and healthy group [(148.9±113.6) vs (89.3±51.8), (59.1±40.3) min] (both P<0.05). Conclusion:Patients with both chronic insomnia and OSA and patients with chronic insomnia only in plateau area have different sleep structures, and both of their sleep quality are lower than the people with normal sleep; patients with both chronic insomnia and OSA could enter deep sleep more quickly after sleep onset.

目的:研究青海地区妊娠晚期OSAHS与产时并发症的关系.方法:收集2018年1月-2019年2月于我院妇产科常规入院准备临产孕妇82例,对82例患者数据AHI分为四组:正常组、轻度OSAHS组、中度OSAHS组、重度OSAHS组,同期对所有孕妇进行EPO,TNF-a、IL-6化验检查.结果:①正常组、轻度OSAHS组、中度OSAHS组、重度OSAHS组妊娠期高血压的发病率分别为:9.1％、8.3％、3.6％、50.0％,四组妊娠期子痫的发病率分别为:0、8.3％、0、25.0％,四组妊娠期糖尿病的发病率分别为:9.1％、16.7％、14.3％、75.0％,四组低体重出生儿的发生率分别为:0、4.2％、17.9％、37.5％;且各组差异具有统计学意义(P＜0.05);②AHI与各项指标的相关性分析显示:AHI与孕期体重增加呈正相关(r=0.741,P＜0.05),AHI与孕期BMI增加呈正相关(r=0.862,P＜0.05),AHI与浅熟睡时间呈正相关(r=0.731,P＜0.05),AHI与肿瘤坏死因子呈正相关(r=0.421,P＜0.05);③孕期BMI增长与各项指标的相关性分析显示:孕期BMI增加与浅睡时间呈正相关(r=0.713,P＜0.05),孕期BMI增长与肿瘤坏死因子呈正相关(r=0.453,P＜0.05).结论:高原孕晚期女性OSAHS发生率较高;在高原孕晚期女性OSAHS的发生会增加妊娠高血压、妊娠期子痫、妊娠期糖尿病以及体重出儿的发生风险;关注孕晚期女性孕期体重增长将有助于早期发现妊娠期OSAHS发生.

目的:探讨青藏高原地区老年人睡眠监测指标与衰弱情况之间的关系.方法:以衰弱指数量表调查结合标准多导睡眠监测情况.对青海红十字医院老年科住院体检的63～93岁(80.5)老人29名体检情况进行分析.结果:血红蛋白、 衰弱等级、REM潜伏期在80岁以下组及80岁以上(包括80岁)两个年龄组间差异有统计学意义(P<0.05);平均红细胞体积与TOTAL氧减指数在不同程度的OSAHS组(AHI1-4.99正常,5～14.99轻度,15～29.99中度,30以上重度)间差异有统计学意义(P<0.05);衰弱指数与睡眠监测指标的相关性分析显示:衰弱指数与年龄呈正相关(r=0.495),与血红蛋白呈负相关(r=-0.473)、 与白蛋白呈负相关(r=-0.626),相关性有统计学意义(P<0.01);与REM潜伏期呈正相关(r=0.381),与总胆固醇呈负相关(r=-0.395)、 与高密度脂蛋白呈负相关(r=-0.412),相关性有统计学意义(P<0.05).AHI指数与睡眠监测指标的相关性分析显示:AHI指数与TOTAL氧减指数呈正相关(r=0.964)、 与高密度脂蛋白呈正相关(r=0.533),相关性有统计学意义(P<0.01);与白蛋白呈正相关(r=0.449)、 与白球比呈正相关(r=0.380)、 与血糖呈正相关(r=0.416),相关性有统计学意义(P<0.05).结论:衰弱指数与年龄、REM潜伏期、 血红蛋白、 白蛋白、 总胆固醇、 高密度脂蛋白之间具有相关性.AHI指数与TOTAL氧减指数、 高密度脂蛋白、 白蛋白、 白球比、 血糖之间具有相关性.