UPPP手术治疗对于重度OSAHS患者左心室舒张功能及充盈模式的影响  

Effect of UPPP treatment on left ventricular diastolic function and filling pattern in patients with severe OSAHS

作　　者：张欣 徐彧[2] 徐明[2] 王丙剑[2] 吕凌云[2] 林宁 黄春梅 ZHANG Xin;XU Yu;XU Ming;WANG Bingjian;LV Lingyun;LIN Ning;HUANG Chunmei(ENT Hospital of Huaian,Jiangsu 223300,China)

机构地区：[1]江苏淮安市耳鼻咽喉医院,223300 [2]南京医科大学附属淮安第一医院

出　　处：《中国中西医结合耳鼻咽喉科杂志》2021年第2期127-131,共5页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：江苏淮安市自然科学研究计划(编号:HAB201946)。

摘　　要：目的研究UPPP手术治疗重症OSAHS对其左心室舒张功能及充盈模式的影响。方法观察组来自在我院耳鼻咽喉科诊断明确的重症OSAHS患者80例,其中40例行UPPP术式治疗;另外40例采用非手术方案治疗;对照组来自同期PSG监测非OSAHS患者,分为单纯高血压病患者及正常健康对照组。所有研究对象均采用超声心动图检测,对实验组进行6个月随访后再采用超声心动图评估。比较治疗前后二尖瓣血流频谱舒张早期与晚期最大血流比(E/A)、二尖瓣血流舒张早期峰值(E)与舒张早期二尖瓣环运动速度(E’)比(E/E’)、左心室射血分数(LVEF)、左心室舒张末内径(LVEDD)、左心室等容舒张时间(LVRT)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)的变化。结果与治疗前及HTN组比较,UPPP组治疗后E/E’比值、LVEF(%)、LVRT明显提高,而LVEDD、IVST、LVPWT明显降低,其差异均有统计学意义(P<0.05);非手术组治疗后左心室舒张功能参数差异均无统计学意义(P>0.05)。与正常人比较,UPPP组治疗后左心室舒张功能参数改善,其差异均无统计学意义(P>0.05);非手术组治疗前后左心室舒张功能参数无明显改善(P<0.05)。重度OSAHS手术组行UPPP治疗前后左心室舒张期充盈模式的差异具有统计学意义(P<0.05),而非手术组治疗前后左心室舒张期充盈模式的差异无统计学意义(P>0.05)。结论重度OSAHS部分患者存在不同程度的左心室舒张功能障碍,经过手术干预后受损的左心室舒张功能得到改善和部分逆转。Objective To investigate the effect of uvulopalatopharyngoplasty(UPPP)on left ventricular diastolic function and filling pattern in patients with severe OSAHS.Methods 80 patients with severe OSAHS were randomly divided into two groups,40 patients were performed with UPPP treatment,which accepted tissue Doppler imaging(TDI)ultrasonography before and 6 months after the treatment.The other 40 patients were treated with non-surgical treatment.The control group was from non OSAHS patients monitored by PSG at the same time,40 patients with pure Hypertension and 40 healthy people.All the subjects were examined by TDI for the assessment of Late early diastolic mitral valve flow spectrum and maximum flow ratio(E/A),E/E’,Left ventricular ejection fraction(LVEF),Left ventricular end-diastolic diamete(LVEDD),left ventricular isovolumetric relaxation time(LVRT),Interventricular septal thickness(IVST)and Left ventricular posterior wall thickness(LVPWT).Result Compared with before treatment and HTN group,the E/E’,LVEF(%)and LVRT in UPPP group were significantly increased,while LVEDD,IVST and LVPWT were significantly decreased(P<0.05);there was no significant difference in parameters of left ventricular function(LVF)in non-operative group after therapy(P>0.05).Compared with healthy people,the parameters of LVF in UPPP group were improved after therapy(P>0.05),and no significant improvement of left ventricular diastolic function was found in the non-operative group before and after therapy(P<0.05).There was significant difference in left ventricular diastolic filling pattern in UPPP group before and after surgical therapy(P<0.05),but the difference of left ventricular diastolic filling pattern in non-operation group was not statistically significant before and after therapy(P>0.05).Conclusion It is suggested that some patients with severe OSAHS have different degrees of left ventricular diastolic dysfunction.UPPP therapy is helpful to reverse the damaged left ventricular structural and changes to improve ventricular diastolic

关 键 词：睡眠呼吸暂停 阻塞性 悬雍垂腭咽成形术 超声心动图 心室功能 心室充盈模式 左 

分 类 号：R766[医药卫生—耳鼻咽喉科]