阻塞性睡眠呼吸暂停低通气综合征伴咽喉反流性疾病患者的临床分析  

Clinical analysis of obstructive sleep apnea hypopnea syndrome combined with throat reflux disease

作　　者：秦超[1] 王新[1] 曾建明[1] QIN Chao;WANG Xin;ZENG Jianming(Department of Respiratory and Critical Care Medicine,Deyang People's Hospital,Deyang 618000,Sichuan,China)

机构地区：[1]德阳市人民医院呼吸与危重症医学科

出　　处：《上海医学》2019年第8期454-457,共4页Shanghai Medical Journal

摘　　要：目的探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与咽喉反流性疾病的相关性。方法选择2017年10月-2019年4月德阳市人民医院呼吸科收治的88例经多导睡眠监测(PSG)等明确诊断为OSAHS且伴有咽喉反流体征的患者,均行PSG、咽喉pH值监测。根据OSAHS患者中伴反流性疾病的情况分为伴咽喉反流组和不伴咽喉反流组,比较两组间的呼吸暂停低通气指数(AHI)、最低动脉血氧饱和度(LSaO2)、>5 min酸反流次数、最长酸清除时间和Demeester评分。比较不同OSAHS严重程度患者伴咽喉反流性疾病的反流情况。结果 88例OSAHS患者中,轻度21例(23.86%),中度38例(43.18%),重度29例(32.95%);伴咽喉反流组31例(35.23%),不伴咽喉反流组57例(64.77%)。伴咽喉反流组与不伴咽喉反流组间的AHI、LSaO2、>5 min酸反流次数、最长酸清除时间和Demeester评分的差异均有统计学意义(P值均<0.01)。伴咽喉反流组中,轻度OSAHS伴反流10例、中度OSAHS伴反流13例、重度OSAHS伴反流8例。随着OSAHS严重程度的加重,患者的酸性反流(χ^2=28.286,P<0.001)和总反流次数均逐渐增多(χ^2=39.125,P<0.001),不同OSAHS严重程度患者间弱酸性反流和非酸性反流次数的差异均无统计学意义(P值均>0.05)。在控制性别、年龄、BMI等影响因素后,logistic回归分析结果显示,病理性酸反流阳性与OSAHS发病呈正相关(OR=5.561,95%CI为1.265~26.168,P=0.026)。结论 OSAHS与咽喉反流性疾病的共患率较高,且酸性物质反流次数会随OSAHS病情加重而增多,临床应该提高重视,加强两病的共治。Objective To explore the correlation between obstructive sleep apnea hypopnea syndrome(OSAHS) and throat reflux disease. Methods A total of 88 OSAHS patients admitted to our hospital between October 2017 and April 2019 were selected for this study. Polysomnography(PSG) and pharyngeal pH monitoring were performed in all the patients. The patients were divided into laryngopharyngeal reflux group and non-laryngopharyngeal reflux group. The apnea hypopnea index(AHI), minimum oxygen saturation(LSaO2), >5 min acid reflux times, maximum acid clearance time and Demeester score were compared between the two groups. The severities of laryngopharyngeal reflux disease were compared in patients with different grades of OSAHS. Results OSAHS was mild in 21 patients(23.86%), moderate in 38 patients(43.18%), and severe in 29 patients(32.95%). There were 31 patients in laryngopharyngeal reflux group(35.23%) and 57 patients in non-laryngopharyngeal reflux group(64.77%). There were significant differences in the AHI, LSaO2, >5 min acid reflux times, maximum acid clearance time and Demeester score between the two groups(all P<0.01). In the laryngopharyngeal reflux group, mild OSAHS occurred in 10 cases(mild subgroup), moderate OSAHS in 13 cases(moderate subgroup), and severe OSAHS in 8 cases(severe subgroup). In the mild, moderate, and severe subgroups, the number of acid reflux(χ^2=28.286, P<0.001) and total reflux increased gradually(χ^2 =39.125, P<0.001), but there was no significant difference in the number of weak acid reflux or non-acid reflux(all P>0.05). After adjustment of gender, age, BMI and other influencing factors, logistic regression analysis showed that positive pathological acid reflux was positively correlated with the onset of OSAHS(OR=5.561,95%CI: 1.265―26.168, P=0.026). Conclusion There is a high comorbidity rate of OSAHS with throat reflux disease. The more frequent the acid reflux, the severer the OSAHS. More attention is needed to strengthen the co-treatment of the two diseases in clinics.

关 键 词：睡眠呼吸暂停 阻塞性 监测 睡眠 咽喉反流性疾病 

分 类 号：R[医药卫生]