口腔矫治器对OSAHS患者白天嗜睡程度及生活质量的影响
【摘要】
目的：采用Epworth嗜睡评分量表（ESS）和Calgary睡眠呼吸暂停生活质量调查表（SAQLI）评价阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者戴用口腔矫治器前后白天嗜睡程度及生活质量的变化，并研究患者治疗前白天嗜睡程度、生活质量与多导睡眠监测（PSG）结果的相关性。
方法：经PSG监测及纳入、排除标准筛选出的35例轻、中度OSAHS患者，行口腔矫治器治疗，并采用ESS问卷及SAQLI问卷对患者戴用口腔矫治器前1周及戴用后3个月白天嗜睡程度及生活质量进行调查，对所获资料进行均数比较、配对t检验、两独立样本t检验及Pearson相关性分析。
结果：轻、中度OSAHS患者AHI、LSaO2、ESS及SAQLI问卷得分在治疗前1周及治疗后3个月的差异有统计学意义（P<0.05）；口腔矫治器治疗客观有效率为88.57%，生活质量总体改善有效率为77.1%。治疗前及治疗后轻度与中度患者各项指标的差异均有统计学意义（P<0.05）。OSAHS患者治疗前ESS、SAQLI得分与AHI、LSaO2存在相关性，ESS得分与SAQLI得分存在相关性（P<0.05）。
结论：口腔矫治器治疗OSAHS具有良好的客观疗效及主观疗效，其疗效与患者的患病程度有关。OSAHS患者主观性评价能在一定程度上反映患病程度，但不能用客观性指标代替对患者生活质量的评价。
【关键词】口腔矫治器；阻塞性睡眠呼吸暂停低通气综合征；白天过度嗜睡；生活质量
The Effects of Oral Appliances on Daytime Sleepiness Extent and Life Quality of OSAHS Patients
Abstract
Objective：To assess the changes in daytime sleepiness and life quality of OSAHS patients after wearing oral appliances by using the Epworth sleepiness scale（ESS）and the Calgary sleep apnea quality of life index（SAQLI），and to study the correlation between daytime sleepiness，life quality，and the result of the polysomnography（PSG）examination.
Methods：Treating 35 mild and moderate OSAHS patients selected through PSG examination，inclusion and exclusion criteria with oral appliances，surveying the patients for their daytime sleepiness and life quality a week before and the three months following therapy with ESS and SAQLI questionnaires，and conducting mean comparison，paired t-test，two-sample t-test and Pearson correlation analysis on the information obtained.
Results：The differences of mild and moderate patients’apnea hyponea index（AHI），lowest blood oxygen saturation（LSaO2），and ESS and SAQLI questionnaire scores between a week before and the three months following wearing oral appliances are of statistical significance（P<0.05）；the objective response rate of the treatment with oral appliances is 88.57%，and quality of life generally improves by 77.1%.The differences of both mild and moderate patients’various indexes before and after treatment are of statistical significance（P<0.05）.Before treatment，OSAHS patients’s ESS and SAQLI questionnaires are correlated with AHI and LSaO2，and the ESS scores are correlated with the SAOLI scores（P<0.05）.
Conclusion：Wearing oral appliances has positive objective and subjective curative effects on OSAHS.Its efficacy was related to the degree of disease of the patients.To some extent，the OSAHS patients’subjective assessment can reflect the degree of their disease，but the objective indicators can not be used to replace the evaluation of patients’life quality.
Key words：oral appliance；OSAHS；excessive daytime sleepiness；quality of life