肥胖阻塞型睡眠呼吸暂停综合征患者肺功能、酸反流及食管动力学特点分析  

Analysis of pulmonary function,acid reflux and esophageal dynamics in obese with obstructive sleep apnea syndrome patients

作　　者：祖里培亚·艾拜都拉[2] 苟安栓[1] 买买提·依斯热依力 凌敏[1] 艾克拜尔·艾力[2] 牛灵[1] 克力木·阿不都热依木[2] Zulipeiya·Abaidula;Gou Anshuan;Maimaiti·Yisireyili;Ling Min;Aikebaier·Aili;Niu Ling;Kelimu·Abudureyimu(Department of Respiratory and Critical Care Medicine,People's Hospital of Xinjiang Uygur Autunomous Region,Urumqi 830001,China;Department of Minimally Invasive Surgery,Hernia and Abdominal Wall Surgery,People's Hospital of Xinjiang Uygur Autunomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院呼吸与危重症医学中心,乌鲁木齐830001 [2]新疆维吾尔自治区人民医院微创外科,乌鲁木齐830001

出　　处：《中华胃食管反流病电子杂志》2020年第3期167-171,共5页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

基　　金：新疆维吾尔自治区自然科学基金(2018D01C134)。

摘　　要：目的探讨肥胖合并阻塞型睡眠呼吸暂停综合征(OSAS)患者的肺功能、酸反流以及食管动力学特征。方法回顾性分析2019年3月至2019年12月于新疆维吾尔自治区人民医院呼吸与危重症医学中心住院治疗的82例肥胖患者的临床资料。经多导睡眠监测(PSG)确诊并符合OSAS诊断标准的患者,进一部分为OSAS组(n=42例)和非OSAS组(n=40例)。收集患者的肺功能,GERD问卷调查,24 h pH检测以及食管动力学检测结果,分析各因素在OSAS发生中的特点。结果经PSG分析发现,OSAS组呼吸暂停低通气指数高于非OSAS组,其最低动脉血氧饱和度(SaO_(2)%)低于非OSAS组,差异具有统计学意义(t=1.979,1.853;P<0.05)。OSAS组用力肺活量(FVC)和第一秒用力呼气容积(FEV_(1))显著低于非OSAS组,而功能残气量(FRC)明显高于非OSAS组,差异均具有统计学意义(t=2.012,1.964,1.883;P<0.05)。OSAS组睡眠障碍者显著高于非OSAS组,且差异具有统计学意义(F=5.628,P<0.05);24 h食管pH检测显示,OSAS组酸反流次数、总酸反流次数及DeMeester评分均显著高于非OSAS组,差异具有统计学意义(t=3.157,4.102,5.213;P<0.05)。OSAS组LES静息压力低于非OSAS组;UES静息压力高于非OSAS组,差异具有统计学意义(t=2.114,1.915;P<0.05)。结论肥胖患者中OSAS与肺功能改变、酸反流及食管动力异常有关,三者互为促进,相互影响。Objective To investigate the pulmonary function,acid reflux and esophageal dynamics in obese patients with obstructive sleep apnea syndrome(OSAS).Methods A retrospective analysis was made of 82 obese patients who were hospitalized in the respiratory and critical care medical center in our hospital from March 2019 to December 2019.According to the clinical data,the patients who were diagnosed by PSG and met the diagnostic criteria of OSAS were included in the OSAS group(n=42 case)and non OSAS group(n=42 case).The characteristics of OSAS were analyzed by lung function,GERD questionnaire,24-hour pH test and esophageal dynamics test.Results The PSG analysis showed that the AHI index of OSAS group was higher than non OSAS group,and SaO_(2)% were lower than non OSAS group(P<0.05);FVC and FEV_(1) in OSAS group were significantly lower than those in non OSAS group,while FRC was significantly higher than those in non OSAS group(P<0.05);sleep disorders in OSAS group were significantly higher than OSAS group(P<0.05);24-hour esophageal pH test showed that the number of acid reflux,total acid reflux and DeMeester score in the OSAS group were significantly higher than those in the non OSAS group(P<0.05);the esophageal motility test showed that the LES resting pressure in the OSAS group was lower,and the UES resting pressure was higher than that in the non OSAS group(P<0.05).Conclusion OSAS in obese patients is related to the change of pulmonary function,acid reflux and esophageal motility,which can promote and influence each other.

关 键 词：肥胖 阻塞型睡眠呼吸暂停综合征 肺功能 酸反流 食管动力 

分 类 号：R766[医药卫生—耳鼻咽喉科]