UPPP治疗OSAHS效果及对ET-1、HIF-1α、IL-18和咽喉反流症状的影响  

Effect of UPPP on the treatment of OSAHS and its influence on ET-1,HIF-1α,IL-18,and throat reflux symptoms

作　　者：韩勇 张强 HAN Yong;ZHANG Qiang(Department of Otorhinolaryngology,the People's Hospital of Dazu,Chongqing,China,402360;Department of Respiratory and Critical Care Medicine,the People's Hospital of Dazu,Chongqing,China,402360)

机构地区：[1]重庆市大足区人民医院耳鼻喉科,重庆402360 [2]重庆市大足区人民医院呼吸与危重症医学科,重庆402360

出　　处：《分子诊断与治疗杂志》2022年第2期282-285,290,共5页Journal of Molecular Diagnostics and Therapy

摘　　要：目的研究悬雍垂腭咽成形术(UPPP)治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床效果及对内皮素-1(ET-1)、缺氧诱导因子1α多肽(HIF-1α)、白介素18(IL-18)、咽喉反流症状的影响。方法选取2017年1月至2020年1月于重庆市大足区人民医院就诊的98例OSAHS患者,根据治疗方案的差异分为通气组和UPPP组各49例。其中通气组采用鼻通气手术,UPPP组患者采用UPPP。比较两组术后1周ET-1、HIF-1α、IL-18水平及6个月临床疗效、临床症状[鼻阻力、鼻塞视觉模拟(VAS)、白天嗜睡主观评分Epworth嗜睡量表(ESS)]、咽喉反流症状,观察术后并发症发生情况。结果术后1周,两组ET-1、HIF-1α、IL-18水平均显著降低,且UPPP组显著低于通气组,差异有统计学意义(P<0.05)。术后6个月,UPPP组有效率显著高于通气组,差异有统计学意义(P<0.05)。术后6个月,两组鼻阻力值、VAS及ESS评分均显著降低,且UPPP组显著低于通气组,差异有统计学意义(P<0.05)。术后6个月,UPPP组患者咽喉反流症状、体征评分均显著低于通气组,差异有统计学意义(P<0.05)。两组均无鼻腔粘连、鼻咽闭锁不全、鼻中隔穿孔、开放性鼻音等术后并发症。结论 UPPP治疗能改善OSAHS患者血清炎症指标及咽喉反流症状,且临床有效率较高。Objective To study the clinical effects of uvulopalatopharyngoplasty(UPPP)in the treatment of obstructive sleep apnea-hyperpnoea syndrome(OSAHS),and its influence on endothelin-1(ET-1),hypoxia-inducible factor 1α polypeptide(HIF-1α),interleukin 18(IL-18),and throat reflux symptoms.Methods A total of 98 patients with OSAHS who were treated in Dazu District People ’ s Hospital of Chongqing from January 2017 to January 2020 were selected and divided into ventilation group and UPPP group with 49 cases in each group according to the difference in treatment plan. The levels of ET-1,HIF-1α,and IL-18 at 1 week after operation,as well as the clinical efficacy,clinical symptoms[nasal resistance,visual analogue(VAS)of nasal obstruction,and subjective score of daytime sleepiness Epworth Sleepiness Scale(ESS)],laryngopharyngeal reflux symptoms at 6 months after operation were compared between the two groups. The postoperative complications were observed. Results One week after operation,ET-1,HIF-1α,IL-18 levels in the two groups were significantly reduced,the UPPP group was significantly lower than the venting group,and the difference was statistically significant(P<0.05). Six months after operation,the effective rate in the UPPP group was significantly higher than that in the ventilation group,and the difference was statistically significant(P<0.05). The nasal resistance,VAS and ESS socre of the two groups were significantly decreased,the UPPP group was significantly lower than the venting group,and the difference was statistically significant(P<0.05). Six months after operation,the symptoms and signs of laryngopharyngeal reflux in the UPPP group were significantly lower than those in the ventilation group,and the difference was statistically significant(P<0.05). Conclusion UPPP treatment can improve serum inflammatory indicators and laryngopharyngeal reflux symptoms in patients with OSAHS,and the clinical efficacy rate is high.

关 键 词：UPPP OSAHS ET-1 HIF-1Α IL-18 咽喉反流 

分 类 号：R766.5[医药卫生—耳鼻咽喉科]