重度OSAHS患者鼻通气功能状态的研究  

Study of Nasal Ventilatory Function in Patients with Severe Obstructive Sleep Apnea Hypopnea Syndrome

作　　者：肖彩霞[1] 鲁宏华[2] 阮宏莹[2] 林鹏[2] 王巍[2] 杨翠红[1] 王丽生[2] 

机构地区：[1]天津医科大学一中心临床学院,300192 [2]天津市第一中心医院耳鼻咽喉头颈外科,天津市耳鼻喉科研究所

出　　处：《天津医药》2013年第6期576-579,共4页Tianjin Medical Journal

摘　　要：目的评估无鼻阻塞亦无明显鼻腔结构异常的重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的鼻通气功能状态。方法 102例健康正常人为对照组,77例无鼻阻塞亦无明显鼻腔结构异常的重度OSAHS为观察组。应用鼻声反射、鼻阻力及鼻呼吸量测量法测量2组鼻通气功能,测量指标包括鼻腔最小截面积(MCA)、鼻腔最小截面积距前鼻孔距离(DCAN)、鼻腔0～5cm容积(V5)、2～5cm容积(V2～5);单侧鼻腔吸气阻力(IR)、呼气阻力(ER)、计算双侧吸气总阻力(TIR)、双侧鼻腔呼气总阻力(TER);双侧鼻腔吸气量(IC)、呼气量(EC)、鼻呼吸量差异比(NPR)[包括吸气量差异比(NPRi)及呼气量差异比(NPRe)];将2组间参数进行比较。结果与正常组比较,观察组IR、ER、TIR、TER、IC、EC、NPRi、NPRe均增大;V5、V2～5均减小(P<0.05或P<0.01)。结论无鼻阻塞亦无明显鼻腔结构异常的重度OSAHS患者鼻通气功能存在异常,OSAHS患者咽部阻塞可以引起鼻通气功能的变化。Objective To study the nasal ventilatoly function of severe obstructive sleep apnea hypopnea syndrome （OSAHS） patients without nasal obstruction and obvious nasal anatomy anomalies. Methods There were 102 healthy individuals in control group and 77 patients with severe OSAHS and without nasal obstruction and obvious nasal anatomy anomalies in observation group in this study. Acoustic rhinometry was used to measure the minimum cross-sectional area （MCA）, distance of the minimal cross-sectional area to the nostril （DCAN） and the nasal volume from 0 to 5 cm, 2 to 5 cm （Vs, V2-5）. Rhinomanometry was used to measure unilateral nasal inspiratory resistance （IR） and expiratory resistance （ER）, total bilateral inspiratory resistance （TIR） and total bilateral expiratory resistance （TER）. Rhinospirometer was used to measure unilateral inspiratory capacity （IC）, expiratory capacity （EC） and the nasal partitioning ratio （NPR）. Parameters were compared between two groups. Results Compared to control group, values of IR, ER,TIR, TER, IC, EC, NPRi and NPRe were all significantly higher （P 〈 0.05 or P 〈 0.01） while values of V5 and V2-5 were significantly lower （P 〈 0.05 or P 〈 0.01） in observation group. Conclusion The nasal ventilatory function is abnormal in the severe OSAHS patients without nasal obstruction and obvious nasal anatomy anomalies. The pharyngeal obstruction in the OSAHS could cause the change in the nasal ventilatory function.

关 键 词：睡眠呼吸暂停 阻塞性 睡眠呼吸暂停综合征 鼻测量 声学 鼻腔测压 鼻 炎症 鼻呼吸量 鼻功能 

分 类 号：R276.152.1[医药卫生—中医五官科学]