咽部手术对OSAHS患者ASCVD总体发病风险的影响  

Effect of pharyngeal surgery on the risk of ASCVD in patients with OSAHS

作　　者：尚静 李硕 刘玉璞[3] 关建[3] 怀德 张国桃 SHANG Jing;LI Shuo;LIU Yupu;GUAN Jian;HUAI de;ZHANG Guotao(Department of Otolaryngoloy,Huaian Hospital Affiliated to Xuzhou Medical University,Huaian Second People’s Hospital,Huaian,Jiangsu,223002,China)

机构地区：[1]江苏徐州医科大学附属淮安医院淮安市第二人民医院耳鼻咽喉科,223002 [2]江苏徐州医科大学附属淮安医院淮安市第二人民医院药学部 [3]上海交通大学附属第六人民医院耳鼻咽喉科头颈外科

出　　处：《中国中西医结合耳鼻咽喉科杂志》2022年第5期383-387,395,共6页Chinese Journal of Otorhinolaryngology in Integrative Medicine

基　　金：江苏省卫健委科研立项面上项目(H2017012);2019江苏省淮安市自然科学研究计划(指导性)项目(HABZ201901)。

摘　　要：目的探讨咽部手术对阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者动脉粥样硬化性心血管疾病(ASCVD)总体发病风险的影响。方法行咽部手术OSAHS患者74例,整理患者手术前后PSG参数、代谢指标,按照中国成人血脂异常防治指南进行ASCVD总体发病危险的分组,并进行统计学分析。结果OSAHS患者远期发生ASCVD总体发病风险较高,其中41~50岁和51岁及以上年龄组,合计占相应分层人数的比例为77.8%和90%;OSAHS患者行咽部手术后AHI、CT90,ODI、IR、TC、LDL-C、n-HDL、Apo B、BMI、BP降低,LSaO_(2)升高,具有统计学意义(P<0.05);代谢异常、吸烟及TC异常的OSAHS患者,术后远期发生ASCVD发病风险降低。结论OSAHS患者远期发生ASCVD总体发病风险较高,咽部手术能降低AHI、CT90、ODI、IR、TC、LDL-C、n-HDL、Apo B等指标,并提高LSaO_(2);并降低术前已出现代谢异常、TC异常及吸烟患者的ASCVD10年总体发病风险。Objective To investigate atherosclerotic cardiovascular disease(ASCVD)risk after pharyngeal surgery in patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods A total of 74 patients with OSAHS underwent pharyngeal surgery were enrolled in the study.PSG parameters and metabolic indexes were sorted out before and after operation.According to the guidelines for prevention and treatment of dyslipidemia in Chinese adults,the overall risk of ASCVD was grouped and statistically analyzed.Results The overall risk of developing ASCVD in patients with OSAHS was higher in the long term.Among them,41~50 years old and 51 years old and above accounted for 77.8% and 90% of the corresponding population.After pharyngeal surgery in OSAHS patients,AHI,CT90,ODI,IR,TC,LDL-C,n-HDL,ApoB,BMI and BP decreased,while LSaO_(2) increased,with statistical significance(P<0.05).OSAHS patients with abnormal metabolism,smoking and abnormal TC have a lower risk of developing ASCVD in the long term after operation.Conclusion The overall risk of ASCVD in patients with OSAHS is higher in the long term.Pharyngeal surgery can reduce the indexes of AHI,CT90,ODI,IR,TC,LDL-C,n-HDL and ApoB and increase LSaO_(2).It also could reduce overall 10-year risk of ASCVD in patients with metabolic abnormalities,TC abnormalities and smoking habits before operation.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 动脉粥样硬化性心血管疾病 咽部手术 总体发病风险评估 

分 类 号：R766[医药卫生—耳鼻咽喉科] R54[医药卫生—临床医学]