Nocturnal Intermittent Serious Hypoxia and Reoxygenation in Proliferative Diabetic Retinopathy Cases
Nocturnal Intermittent Serious Hypoxia and Reoxygenation in Proliferative Diabetic Retinopathy Cases
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DOI：
10.1016/j.ajo.2010.01.006
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发表时间：
2010-06-01
影响因子：
4.2
通讯作者：
Takahashi, Mao
中科院分区：
文献类型：
--
作者：
Shiba, Tomoaki;Maeno, Takatoshi;Takahashi, Mao
目的：详细阐明睡眠呼吸障碍评价项目与糖尿病视网膜病变之间的关系。设计：横断面比较研究。方法：本研究纳入在我科接受手术的连续68例非增殖性糖尿病视网膜病变和151例增殖性糖尿病视网膜病变（PDR）病例。过夜进行脉搏血氧测定，并计算脉搏血氧计的平均血氧饱和度（SpO(2)；%）、睡眠 4% 血氧饱和度指数（4% ODI 次/小时）、最低 SpO(2) (%) 以及 SpO(2) < 90% 的累积时间百分比（CT 90%）。对2组的结果进行评价和比较。此外，使用逻辑回归分析对这些结果和术前患者背景因素进行分析，以明确 PDR 的危险因素。 结果：PDR 组的 4% ODI 和 CT 90% 显着高于非增殖性糖尿病视网膜病变组（4% ODI，7.8 vs. 4.9；P = .007；CT 90%，2.2 vs 0.8；P =.0006）。 PDR 组的最低 SpO(2) 显着低于非增殖性糖尿病视网膜病变组（82.4 vs 87.0；P = .0006）。 Logistic 回归分析确定较年轻、最低 SpO(2) 值较低和血红蛋白 A1c 值较高是 PDR 的危险因素（年龄：比值比，0.90；95% 置信区间，-0.86 至 -0.94；P < .0001；最低 SpO(2)：比值比，0.93；95% 置信区间，0.88 至 0.99；P = .02；血红蛋白 A1c：比值比，1.00 至 1.69；P = .047)。结论：本研究表明，PDR 病例因睡眠呼吸障碍而出现夜间间歇性缺氧和复氧，且低值最低 SpO(2) 是 PDR 发生的危险因素。 （美国眼科杂志 2010；149：959-963。(C) 2010，Elsevier Inc. 保留所有权利。）
PURPOSE: To clarify the relationship between evaluation items of sleep-disordered breathing and diabetic retinopathy in detail.DESIGN: Cross-sectional comparative study.METHODS: Sixty-eight consecutive nonproliferative diabetic retinopathy and 151 proliferative diabetic retinopathy (PDR) cases who had undergone surgeries in our department were included in this study. Pulse oximetry was conducted overnight and mean oxygen saturation by pulse oximeter (SpO(2); %), the sleeping 4% oxygen desaturation index (4% ODI times/hour), lowest SpO(2) (%), and the cumulative percent time spent at SpO(2) < 90% (CT 90%) were calculated. The results were evaluated and compared between the 2 groups. In addition, these results and preoperative patient background factors were analyzed using logistic regression analysis to clarify risk factor of PDR.RESULTS: 4% ODI and CT 90% in the PDR group were significantly higher than in the nonproliferative diabetic retinopathy group (4% ODI, 7.8 vs. 4.9; P = .007; CT 90%, 2.2 vs 0.8; P = .0006). Lowest SpO(2) was significantly lower in the PDR group than in the nonproliferative diabetic retinopathy groups (82.4 vs 87.0; P = .0006). Logistic regression analysis identified being younger, having a lower value for the lowest SpO(2), and a high hemoglobin A1c value to be risk factors for PDR (age: odds ratio, 0.90; 95% confidence interval, -0.86 to -0.94; P < .0001; lowest SpO(2): odds ratio, 0.93; 95% confidence interval, 0.88 to 0.99; P = .02; hemoglobin A1c: odds ratio, 1.00 to 1.69; P = .047).CONCLUSIONS: This study indicated that PDR cases had episodes of nocturnal intermittent hypoxia and reoxygenation as a result of sleep-disordered breathing and that low-value lowest SpO(2) were the risk factors for PDR development. (Am J Ophthalmol 2010;149: 959-963. (C) 2010 by Elsevier Inc. All rights reserved.)