同期鼻咽手术对阻塞性睡眠呼吸暂停低通气综合征合并高血压患者血清8-异构前列腺素、锰超氧化物歧化酶水平的影响及临床意义  

Effect of simultaneous surgery of nasal cavity and oropharynx on the serum level of 8-isoprostagland in and manganese superoxide dismutase in patients with obstructive sleep apnea hypopnea syndrome and hypertension and its clinical significance

作　　者：戴国平[1] 陆银萍[1] 吕兰[1] 刘龙斌 刘琪[3] 商黎明 DAI Guoping;LU Yinping;LYU Lan;LIU Longbin;LIU Qi;SHANG Liming(Department of Otolaryngology,Shaoxing Hospital of Zhejiang University,Shaoxing People’s Hospital,Shaoxing,Zhejiang,312000,China;Department of Cardiology,Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital),Shaoxing,Zhejiang,312000,China;Clinical laboratory,Shaoxing Hospital of Zhejiang University,Shaoxing People’s Hospital,Shaoxing,Zhejiang,312000,China;Department of Otolaryngology,Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital),Shaoxing,Zhejiang,312000,China)

机构地区：[1]绍兴市人民医院,浙江大学绍兴医院耳鼻咽喉科,浙江绍兴312000 [2]绍兴文理学院附属医院(绍兴市立医院)心内科,浙江绍兴312000 [3]绍兴市人民医院,浙江大学绍兴医院临床检验科,浙江绍兴312000 [4]绍兴文理学院附属医院(绍兴市立医院)耳鼻咽喉科,浙江绍兴312000

出　　处：《中国耳鼻咽喉头颈外科》2020年第11期644-647,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨同期鼻腔扩容联合改良悬雍垂腭咽成形术(Han-UPPP,H-UPPP)治疗合并高血压的阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者血清8-异构前列腺素(8-iso-PG)、锰超氧化物歧化酶(MnSOD)水平的影响及临床意义。方法对阻塞平面同时位于鼻腔、腭咽平面的合并高血压的OSAHS患者同期实施鼻腔扩容、H-UPPP手术。全面分析呼吸暂停低通气指数(AHI)、最低血氧饱和度(LSaO2)、Epworth嗜睡量表(ESS)评分、血压及血清8-iso-PG、MnSOD改善情况。短期随访6个月、长期随访1年。结果患者ESS评分、AHI、LSaO2、8-iso-PG、MnSOD、收缩压、舒张压、平均动脉压,术后6个月、术后1年分别与术前比较,术后6个月、术后1年分别与术前差值之间的比较均有显著性差异(P<0.05)。结论针对阻塞平面位于鼻腔、腭咽平面的合并高血压OSAHS患者同期实施鼻腔扩容联合H-UPPP手术治疗,能明显改善血清中8-Isoprostane、MnSOD水平,缓解机体的氧化应激反应,改善OSAHS相关性高血压,但远期疗效下降明显。OBJECTIVE To study the effect of nasal expansion and H-UPPP on serum 8-iso-PG and serum MnSOD levels in patients of OSAHS combined with hypertension and its clinical significance.METHODS Nasal cavity dilatation and H-UPPP surgery were performed on patients with OSAHS and hypertension at the same time.Comprehensive analysis of the improvement of AHI,LSaO2,ESS score,blood pressure and serum 8-iso-PG and MnSOD was conducted.The patients were reevaluated at 6 months and one year after operation.RESULTS The patient’s ESS score,AHI,LSaO2,8-iso-PG,MnSOD,systolic pressure,diastolic pressure,mean arterial pressure were compared with those before and 6 months and 1 year after operation respectively,and all the parameters had significant differences(P<0.05).CONCLUSION For those patients with OSAHS and hypertension,who are obstructed in the nasal cavity and the pharyngeal plane,nasal dilatation combined with H-UPPP can significantly improve their serum 8-Isoprostane and MnSOD,relieve oxidative stress in the body,and improve OSAHS-related hypertension,while the long-term efficacy has dropped a lot.

关 键 词：睡眠呼吸暂停 阻塞性 高血压 耳鼻喉外科手术 氧化应激 

分 类 号：R766.9[医药卫生—耳鼻咽喉科] R544.1[医药卫生—临床医学]