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42第8期
阻塞性睡眠呼吸暂停综合征伴咽喉反流的临床分析
Clinical analysis of obstructive sleep apnea syndrome with laryngeal reflux
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DOI:
作者:
秦超
Qin Chao
作者单位:
德阳市人民医院
People's Hospital Of Deyang City
关键词:
阻塞性睡眠呼吸暂停低通气综合征;咽喉反流性疾病;口咽pH监测;多导睡眠监测
obstructive sleep apnea-hypopnea syndrome;laryngopharyngeal reflux disease;oropharyngeal pH monitoring;polysomnography
摘要:
目的 探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与咽喉反流性疾病(LPRD)的相关性。方法 回顾性分析2017年3月至2017年11月在我科以睡眠打鼾、憋气为主诉就诊,同步行Dx-pH与多导睡眠监测确诊的成年OSAHS患者的临床资料。结果 92例OSAHS患者中轻度27例,中度33例,重度32例。呼吸紊乱指数(AHI)27.0±18.1,最低血氧饱和度81.1%±8.4%。18例(19.6%)患者伴LPRD(10例为单纯直立位咽喉反流,2例为单纯平卧位咽喉反流,6例直立位、平卧位均存在咽喉反流),其中轻度OSAHS组2例(7.4%);中度OSAHS组5例(15.2%);重度OSAHS组11例(34.4%)。三组LPRD患病率有统计学差异(χ2=7.404,P=0.024)。伴LPRD的OSAHS患者AHI(35.8±17.0)大于不伴LPRD的OSAHS患者(24.9±17.8)(P=0.023);但最低血氧饱和度无统计学差异(79.3%±8.4% vs 81.6%±8.4%)(P>0.05)。结论 OSAHS与LPRD有一定的共患率,且病情越重,LPRD发病率越高。OSAHS患者伴发的咽喉反流仍以直立位为主。伴LPRD的OSAHS患者呼吸紊乱程度更重。但两种疾病相互影响的具体机制,尚需进一步研究。
Objective To explore the relationship of obstructive sleep apnea-hypopnea syndrome (OSAHS) with laryngopharyngeal reflux disease (LPRD). Methods In a retrospective study, clinical data of 92 adult OSAHS patients whose chief complaints were snoring and shortness of breath and diagnosed by polysomnography and undertaken Dx-pH monitoring synchronous from March 2017 to November 2017 were analyzed. Results In 92 patients with OSAHS, 27 were mild, 33 were moderate, and 32 were severe. The apnea-hypopnea index (AHI) was 27.0+18.1, and the lowest blood oxygen saturation was 81.1% + 8.4%. Eighteen cases (19.6%) were accompanied by LPRD(10 upright LPRD,2 supine LPRD,6 LPRD in both position), of which 2 cases (7.4%) were in the mild OSAHS group, 5 in the moderate OSAHS group (15.2%), and 11 in the severe group of OSAHS (34.4%). There was a statistically significant difference in the prevalence of LPRD in the three groups(χ2=7.404,P=0.024). The AHI (35.8+17.0) of OSAHS patients with LPRD was greater than that of OSAHS patients without LPRD (24.9+17.8) (P=0.023), however, there was no statistical difference in the lowest oxygen saturation(79.3%±8.4% vs 81.6%±8.4%)(P>0.05). Conclusions There was a certain rate of coexistence between LPRD and OSAHS, and the more serious of OSAHS, the higher incidence of LPRD. Laryngopharyngeal reflux in OSAHS patient still mainly occurred in upright. Patients of OSAHS who also had LPRD had more severe sleep-disordered breathing. However, further studies on the specific mechanisms of the interaction between the two diseases are needed.
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