【摘要】 目的调查癫痫合并梗阻性睡眠呼吸暂停(OSA)在癫痫患者中的发生率,探讨癫痫和OSA的相互关系。方法从515例癫痫患者中,筛选出可疑合并OSA者行多导睡眠监测,睡眠呼吸紊乱指数(AHI)≥5为确诊OSA;记录癫痫发作情况及其临床特点;对合并中到重度OSA的癫痫患者行2~7个月持续性气道正压(CPAP)治疗。结果癫痫患者中OSA发生率为18.06%;合并OSA的癫痫患者发作频率(5.2±2.5)次/月明显高于单纯癫痫患者(3.3±1.2)次/月(P<0.05);合并OSA的癫痫患者经过CPAP治疗,治疗前后有差别,即治疗后发作频率、ESS、AHI指标要低于治疗前(P<0.05)。结论癫痫合并OSA的发生率高于一般人群;二者可能存在因果关系,即OSA导致了癫痫发作,而癫痫发作又加剧了OSA;治疗并存的OSA可有效控制癫痫发作。更多还原

【Abstract】 Objective The aims of this study was to determine the prevalence of coexistence of OSA with epilepsy and their association with survey items in a group of patients with epilepsy.Methods Five hundred fifteen adult epilepsy patients were prospectively screened for OSA by means of a structured interview.Those in whom OSA was clinically suspected were monitored for a full night by using polysomnography(PSG),and OSA was diagnosed when they had an Apnea/Hypopnea Index(AHI) greater than five;and recorded their seizure information and clinical feature;then,the effect of continuous positive airway pressure(CPAP) on seizure was prospectively analyzed after treatment of a interval(2～11 months) from the diagnosis of OSA.Results Coexistence of OSA with epilepsy was found in 96(18.06%) in all investigated patients.The seizure frequency of the "OSA with epilepsy" patients were more higher than merely epilepsy(5.2±2.5 vs 3.3±1.2)(P<0.01),.After treatment of CPAP,the seizure frequency decreased significantly(P<0.01),Both Epworth Sleepiness Scores(ESS) and Apnea/Hypopnea Index(AHI) also decreased significantly(P<0.01).Conclusion The prevalence of coexistence of OSA with epilepsy more higher than general population;its association may be cause and effect,that is to say OSA can cause epilepsy seizure,however,epilepsy seizure can also aggravate OSA;After treatment of coexistence of OSA,the epilepsy seizure frequency can improve control significantly.更多还原