治疗阻塞性睡眠呼吸暂停的新疗法介绍  

New therapies for obstructive sleep apnea-hypopnea syndrome

作　　者：付晓燕[1] 汪建[1] 

机构地区：[1]广州军区广州总医院耳鼻咽喉科,广州医学硕士510010

出　　处：《医学研究生学报》2015年第2期218-220,共3页Journal of Medical Postgraduates

基　　金：广东省科技计划项目基金(2011B031300023)

摘　　要：阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hypopnea syndrome,OSAHS)是一类常见疾病,可造成多系统功能障碍。当前的治疗方法存在患者依存性低和疗效差等不足。近年来,2种新的疗法在国外正处于临床试验阶段,其中一种方法的原理是基于上气道扩张肌在维持咽腔稳定性中所起的重要作用,利用电刺激颏舌肌扩大咽腔及改善上气道阻力,目前已通过了Ⅱ期临床实验,但研究发现不同患者在呼吸暂停低通气指数(apnea-hypopnea index,AHI)的改善程度方面存在差异,且长期安全性也有待进一步研究;另一种方法是利用一种鼻腔佩戴的双向阀门装置来增加呼气时的鼻阻力,该装置对于睡眠呼吸暂停相关症状的改善效果已得到前期临床试验的证实,且患者依存性好,但对于不同患者在疗效上仍存在差异。Obstructive sleep apnea-hypopnea syndrome（ OSAHS） is a prevalent disorder often associated with multisystem dysfunction. Available therapies are limited by either lack of long-term adherence or low response rates. Two emerging therapies hold promise in providing alternatives to patients with OSA. The first stems from the importance of the upperairway dilator muscles in maintaining pharyngeal stability. Electrical stimulation of the genioglossus muscle improves both upper-airway diameter and ameliorates pharyngeal obstruction. The results of phase Ⅰ and Ⅱ clinical trials hold promise,but the reported improvements in the apnea-hypopnea index vary between subjects and long-term safety needs further studies. The second technology relies on creating an increased expiratory nasal resistance via a bidirectional valve designed to be worn just inside the nostrils. Initial findings of clinical trials suggest reduction in severity of sleep apnea and subjective daytime sleepiness. Considerable heterogeneity in response to the nasal device was noted despite the high adherence rates. It remains unclear which patients will likely benefit from these devices.

关 键 词：阻塞性睡眠呼吸暂停 治疗 舌下神经 鼻腔装置 临床实验 

分 类 号：R766[医药卫生—耳鼻咽喉科]