| Objective:To compare with the difference between general information,PSG testing para-meters,and the level of fasting serum thyroid hormone, fasting thyroid stimulating hormone-thyroid hormone and control in different classification of patients with OSAHS and the control group with simple snoring,and evaluating the main factor that influenced thyroid function and control level by analyzing the correlation with the index,we explore the role of thyroid function and cortisol level in the progression of OSAHS ang their relationship between symptoms of daytime sleepiness,Providing a basis for further research about the clinical diagnosis and development of mechanisms of OSAHS.Methods:A total of eighty-six patients who had the symptoms of snoring and confirmed OSAHS bythe night seven hours PSG detection were enrolled,and the other eighteen patients who had the symptoms of snoring,but confirmed primary snore by the night seven hours PSG detection as a research control.General information of patients were recorded and analysed,including age,gender,body mass index (BMI),Epworth sleepiness scale score (ESS score) and PSG testing parameters which including EEG,EOG,EMG,ECG,leg-movement,sno-ring,oronasal airflow horacoabdomal motion and peripheral oxygen saturation.AHI,arousal index,REM time scale,the lowest oxygen saturation of peripheral oxygen saturation of less than 90%,the proportion of time (LSPO2< 90% ratio) and other data wer analysed and calculated.The morning fasting venous blood of patients were extracted at 8:00am and serum FT3, FT4, TSH and serum cortisol concentration were detected by radioimmunoassa-y.To assess the main factors of thyroid function,cortisol levels and daytime sleepiness, the differences in datas were analysed between different classification and control group,and the thyroid function,cortisol,ESS score and related indexes of sleep monitoring were analysed by correlation analysis.Results:(1)The levels of FT4 and TSH were no significant difference (P> 0.05) between simple snoring group and the mild OSAHS group,but they were gradually decreased between moderate OSAHS group and the severe OSAHS group, which had a statistically significant difference between groups (FT4,P<0.01; TSH, P<0.05); FT3 was no significant difference (P> 0.05) between the groups.(2)The level of control was no significant difference (P>0.05) between simple snoring group and the mild OSAHS group,but it was gradually increased between moderate OSAHS group and the severe OSAHS group, which had a statistically significant difference between groups (FT4, P<0.01; TSH, P<0.05).(3)Simple correlation analysis of FT4 and each indicator:FT4 was positively correlated with the proportion of REM period of time (r=0.613, P=0), the lowest oxygen saturation (r=0.777, P=0),and was negatively correlated with gender (r=-0.232, P=0.018), BMI (r=-0.413, P=0), ESS scores (r=-0.904, P=0), cortisol (r=-0.789, P=0), AHI (r=-0.839, P=0), arousal index (r=-0.61, P=0), LSPO2<90% the proportion of time (r=-0.829, P=0).Multiple linear regression analysis showed that the ESS, LSPO2<90% the proportion of time, arousal index, the lowest oxygen saturation, BMI were the key factors affecting FT4.(4) Simple correlation analysis of TSH and each indicator:TSH was positively correlated with age (r=0.24, P=0.014), the lowest oxygen saturation (r=0.407, P=0), and was negatively correlated with BMI (r=-0.342, P=0), ESS scores (r=-0.754, P=0), FT3 (r=-0.22, P=0.025), cortisol (r=-0.852, P=0), AHI (r=-0.337, P=0), LSPO2<90% the proportion of time (r=-0.797, P=0.006).Multiple linear regression analysis showed that cortisol, BMI, LSPO2<90% the proportion of time, minimum oxygen saturation were the key factors affecting TSH.(5)Simple correlation analysis of control and each indicator:control was positively correlated with BMI (r=0.45, P=0), ESS scores (r=0.81, P=0), AHI (r=0.828, P=0), micro arousal index (r=0.386, P=0), LSPO2<90% the proportion of time (r=0.804; P=0),and was negatively with FT4 (r=-0.789, P=0), TSH (r=-0.852, P=0), REM period time ratio (r=-0.499, P=0), the lowest oxygen desaturation (r=-0.709, P=0). Transforming the control into binary data by pressing the level of control>286nmol/L and ≤286nmol/L, Logistic regression analysis found that ESS score was closely correlated with cortisol, TSH level was a protective factor for cortisol.Conclusion:(1)The level of thyroid function is relatively low in patients with moderate and severe OSAHS, correlated with oxygen, reducing the proportion of REM period of time, elevated arousal index, and which is one of the causes of daytime sleepiness in patients with OSAHS.(2)A high level state of cortisol in patients with OSAHS, affcted by hypoxia, decreased REM period of time proportional and elevated arousal index,is an factor in causing the symptoms of daytime sleepiness.(3)Thyroid hormone levels and cortisol levels in patients with OSAHS exist two-way adjustment mechanism.(4)ESS score is better able to reflect thyroid function, cortisol levels in patients with OSAHS,and may become a simple and reliable screening method on evaluating thyroid funct ion and cortisol level of OSAHS.However,Further study of a large sample is needed to comfir m the view.As reliable,it can be based on ESS score to select late diagnosis and treatment of OSAHS, which can avoid or reduce medical waste of resources, and even economical and practical. |
PDF Full Text Request