BiPAP治疗阻塞性睡眠呼吸暂停低通气综合征患者气道壁厚度及血清炎性因子变化  

The changes of tracheal wall thickness and serum inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome treated by BiPAP

作　　者：王臻[1] 金晓燕[1] 曾健[1] 潘静[1] 

机构地区：[1]上海交通大学医学院附属同仁医院呼吸内科,200336

出　　处：《疑难病杂志》2015年第11期1115-1117,1121,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者经双水平无创正压通气(BiPAP)治疗后气道壁厚度及血清炎性因子的变化。方法选择2013年1—12月OSAHS患者42例,BiPAP治疗前后对其应用磁共振(MR)榆查咽壁组织的厚度以及软腭组织,采集血标本进行血清标志物测定并作比较分析。结果治疗后,患者的咽壁纰织厚度均得到改善,咽后壁软腭后区厚度改善为(8.21±2.54)mm,舌后区减至(9.18±3.26)mm,会厌后区减至(5.17±1.73)mm,且咽侧壁软腭后区厚度改善为(2.67±1.25)mm,舌后区减至(0.82±0.53)mm,会厌后区减至(1.96±0.75)mm,和治疗前相比,差异均具有统计学意义(t=2.372、7.997、5.570、4.349、7.770、7.796,P<0.05);治疗后,患者的软腭组织均有所改善,其中截面积缩短为(324.58±23.54)mm^2,厚度降低至(10.76±1.52)mm,长度缩短为(28.36±3.58)mm,与治疗前相比,差异具有统计学意义(t=14.006、3.507、6.555,P<0.05)。治疗后,患者的血清标志物中CRP降低为(6.62±1.74)g/L,IL-6提升为(2.58±1.37)ng/L,8-异前列腺素改善为(37.36±8.74)ng/L,且硝基络氨酸降低至(0.42±0.19)ng/L,与治疗前相比,差异具有统计学意义(t=4.474、2.208、18.788、16.052,P<0.05)。结论阻塞性睡眠呼吸暂停低通气综合征会导致患者的气道壁厚度、腭组织变化和血清炎性因子明显提升,预先检测对确定治疗措施可起到指导意义。Objective To investigate the changes of tracheal wall thickness and scrum inflammatory factors in patients with obstructive sleep apnea hypopnea syndrome（OSAHS） treated by BiPAP.Methods Selected from January 2013 to December 2013,patients with OSAHS of 42 eases,before and after treatment,using magnetic resonance（MR） to determine pharyngeal wall thickness as well as the soft palate tissue,collected blood samples of serum markers,these indices were measured and compared.Results After treatment,patients＇ pharyngeal tissue thickness were improved,the posterior soft palate wall thickness was improved to（8.21 ±2.54） mm,the lingual region reduced to（9.18 ±3.26） mm,epiglottis region reduced to（5.17 ± 1.73） mm,and the lateral pharyngeal soft palate wall thickness was improve to（2.67 ± 1.25） mm,tongue area reduced to（0.82 ±0.53） mm,epiglottis region reduced to（1.96±0.75） mm,compared with before treatment,the differences were statistically significant（t=2.372,t=7.997,t=5.570,t= 4.349,t=7.770,t=7.796,P0.05）;after treatment,patients＇ soft palate tissues improved,which area is shortened to（324.58 ±23.54） mm^2,the thickness was reduced to（10.76 ± 1.52） mm,length was（28.36 ±3.58） mm,compared with before treatment,the difference was statistically significant（t =14.006,t =3.507,t=6.555,P〈0.05）.After treatment,serum mark CRP reduced to（6.62 ±1.74） g/L,IL-6 upgraded to（2.58 ± 1.37）ng/L,and 8 ISO prostaglandin improved to（37.36 ±8.74） ng/L,and nitro tyrosine reduced to（0.42 ±0.19） ng/L,compared with before treatment,the difference is statistically significant（t=4.474,t=2.208,t= 18.788,t= 16.052,P〈0.05）.Conclusion Obstructive sleep apnea hypopnea syndrome can lead to a significant increase in the thickness of the airway wall,the indicators of the palate and serum inflammatory factors.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 气道壁厚度 软腭组织 炎性标志物 

分 类 号：R766[医药卫生—耳鼻咽喉科]