A Comparison Study on Senior Sleep Apnea with Biostatistical and Biomedical Evaluations

使用生物統計學及生命醫學科學評估老年人睡眠呼吸中止症之比較性研究

唐秉輝(Bing H. Tang)

《南臺灣醫學雜誌》 4卷2期 (2008/09) Pp. 73-90

https://doi.org/10.6726/MJST.200809_4(2).0002

摘要

目的：本研究為透過生物統計學及生命醫學科學觀點之比較性研究，探討有/無脂蛋白本體之老年人與睡眠呼吸中止症之關連。方法：選定124位（女：男＝1:1.7）具有睡眠困擾之老年人參與多種睡眠描記法。所得之結果做為後續研究之架構。並透過一篇已出版之論文作為生物統計學上之比較。其他採用生命醫學科學觀點取向之論文，則應用於後續之討論。結果：顯示脂蛋白本體帶原者及非脂蛋白本體帶原者的標準差有明顯的差距。染色體研究和阻塞性睡眠呼吸中止症間的關係、性別差異在APOE基因型和認知退化間、不同的基因型態影響認知測驗的可能性、認知測驗分數以及符號數字形式測驗分數的下降與高度緊密之腦部膨脹及腦部白質的結合具高度交互關聯作用，上述介於動物與人類之差異研究已進行相關分析。結論：我們必須重視以下四點：（1）具有損害性睡眠呼吸中止症者可能因而早逝，以此看來，活至65歲以上則可謂為倖存者；（2）脂蛋白本體基因型狀態和睡眠呼吸中止之間的聯合作用；（3）生物統計科學原則；（4）老年人睡眠呼吸中止症含括非生物性及生物性範圍之認知損害。

關鍵字

窒息／呼吸運動指標 ； 脂蛋白本體 ； 睡眠呼吸中止症 ； 老年人

並列摘要

Purpose: The aim of this study was to explore the senior sleep apnea/fragmentation, without/with apolipoprotein (APOE) e4 from viewpoints of biostatistics and biomedicine by presenting a comparison study. Methods: The 124 (F:M=1:1.7) seniors with sleep disturbance encountered polysomnography (PSG) study. The results are structured as the framework for discussion. A published article is used for comparison biostatistically. Another approach from biomedical viewpoint is then applied for further discussion with additional articles used for the comparison.Results: The biostatistical issues include but not limiting to an obviously wide interval in the standard deviations for APOE e4 carriers and non-carriers, the statistical 'mechanism', the random fluctuation and the artificial 'targeting' in sampling methodology. Relationships between chromosomal study and obstructive sleep apnea, the gender difference between APOE genotype and cognitive decline, the possibility of different genes affecting cognitive tests, the high intercorrelations among cognitive test scores along with associations between decline on symbol digit modality test score and hyperintensities of cerebral periventricular and deep brain white matter, along with differences between animal and human studies are analyzed.Conclusions: We have to respect 1] people with adverse sleep apnea may die off earlier so those who get to their 65 and over are survivors; 2] an association between APOE e4 genotype status and sleep apnea; 3] the biostatistical science principles, and 4] the realization of cognition impairing in covering both non-biological and biological realms on senior sleep apnea.

並列關鍵字

apnea/hypopnea index (AHI) ； biostatistics ； APOE e4 ； sleep apnea ； elderly