Sažetak | Ciljevi: Ciljevi ovog istraživanja bili su proučiti nalaze cjelonoćne polisomnografije/poligrafije
(PSG/PG) u pacijenata s preklapajućim i alternativnim preklapajućim sindromom te istražiti
parametre zasićenosti krvi kisikom (indeks desaturacije, najnižu i srednju zasićenost, vrijeme
provedeno sa zasićenošću manjom od 90%) i težinu OSA-e iskazanu vrijednošću AHI te
dobivene nalaze usporediti s nalazima pacijenata koji imaju samo OSA-u.
Pacijenti i postupci: Istraživanje je uključivalo 220 pacijenata, u dobi od 18 do 90 godina.
Muškaraca je bilo 145, a žena 75. Od 220 sudionika, 22 ih je bolovalo od preklapajućeg, 80 od
alternativnog preklapajućeg sindroma i šest od OSA-e, KOPB-a i astme istovremeno, dok ih je
112 bilo u kontrolnoj skupini koji su imali samo OSA-u. Pacijentima je obavljena dijagnostička
pretraga cjelonoćne PGS/PG u Centru za medicinu spavanja Medicinskog fakulteta u Splitu i
KBC-a Split. Prije snimanja pacijentima je neinvazivno izmjeren arterijski tlak, prikupljeni su
demografski i antropometrijski podatci te anamnestički podatci o dosadašnjim bolestima i
lijekovima ako ih uzimaju što čini dijagnostički algoritam Centra za medicinu spavanja Split.
Svi podaci pacijenata bili su arhivirani u anonimiziranom obliku u digitalnom arhivu Centra za
medicinu spavanja. Istraživanje je započelo je u travnju 2023. te je trajalo do srpnja 2023.
godine.
Rezultati: Od promatranih skupina, pacijenti s preklapajućim sindromom (N=22, 10%) bili su
stariji (62,14±9,99 godina) u odnosu na pacijente s alternativnim preklapajućim sindromom
(N=80, 36,36%) (55,23±11,56 godina, P=0,006). Oni su bili mlađi i od skupine koja
istovremeno boluje od OSA-e, KOPB-a i astme (N=6, 2,73%) (67,50±4,51 godina, P=0,006).
Pacijenti s preklapajućim sindromom imali su nižu srednju zasićenost kisikom (91,88±3,92%,
P=0,006) i duže vrijeme su tijekom spavanja proveli sa zasićenošću krvi kisikom ispod 90%
(157,57±170,66 min) u odnosu na kontrolnu skupinu (N=108, 49,09%) (93,95±2,46%,
41,97±82,07 min, P=0,008). Skupina ispitanika s alternativnim preklapajućim sindromom
provela je tijekom spavanja kraće vrijeme sa zasićenošću krvi kisikom ispod 90%
(59,89±102,32 min) u odnosu na skupinu sa preklapajućim sindromom (P=0,008). AHI, ODI i
najniža zasićenost kisikom nisu se statistički značajno razlikovale između pojedinih skupina.
Zaključak: Pacijenti s preklapajućim sindromom imali su nižu zasićenost kisikom i tijekom
spavanja duže vrijeme proveli su sa zasićenošću krvi kisikom ispod 90% u odnosu na kontrolnu
skupinu. Nadalji ti pacijenti imali su lošiji nalaz PSG/PS u odnosu na skupinu pacijenata s
alternativnim preklapajućim sindromom. |
Sažetak (engleski) | Objectives: The objectives of this study were to study the findings of full-night
polysomnography/polygraphy (PSG/PG) in patients with overlap and alternative overlap
syndromes and to investigate parameters of blood oxygen saturation (desaturation index, lowest
and mean saturation, time spent with saturation less than 90%) and severity of OSA expressed
by the AHI index, and to compare the obtained findings with the findings of patients who only
have OSA.
Patients and methods: The research included 220 patients, aged 18 to 90 years. There were
145 men and 75 women. Of the 220 patients, 22 suffered from overlap, 80 from alternative
overlap syndrome and six from OSA, COPD and asthma simultaneously, while 112 of them
were in the control group who only had OSA. Full-night PSG/PG was performed on the patients
at the Sleep Medicine Center of the University of Split School of Medicine and KBC Split.
Before PSG/PG, patients' arterial pressure was measured non-invasively, and demographic,
anthropometric data and medical history were taken, which makes up the diagnostic algorithm
of the Sleep Medicine Center. All patient data were archived in an anonymized form in the
digital archive. The research began in April 2023 and lasted until July 2023.
Results: Of the observed groups, patients with overlap syndrome (N=22, 10%) were older
(62,14±9,99 years) compared to patients with alternative overlap syndrome (N=80, 36.36%)
(55,23±11,56 years, P=0.006). They were also younger than the group suffering from OSA,
COPD and asthma (N=6, 2.73%) (67,50±4,51 years, P=0.006). Patients with overlap syndrome
had lower mean oxygen saturation (91,88±3,92%, P=0.006) and spent longer time with
saturation below 90% (157,57±170,66 min) compared to the control group (N=108, 49.09%)
(93,95±2,46%, 41,97±82,07 min, P=0.008). The group of patients with alternative overlap
syndrome spent a shorter time saturated below 90% compared to the group with overlap
syndrome (59,89±102,32 min, P=0.008). AHI, ODI and lowest oxygen saturation were not
statistically significantly different between the groups.
Conclusion: Patients with overlap syndrome had lower oxygen saturation and spent a longer
time with saturation below 90% compared to the control group. They had worse PSG/PG results
compared to the group of patients with alternative overlap syndrome. |