以鼻腔阻塞为主的鼾症患者临床特征分析  

Analysis of clinical characteristics of snoring patients with nasal obstruction as the main factor

作　　者：王梓敬 彭本刚 陈默 来佑靑 杨静 杨阳 WANG Zijing;PENG Bengang;CHEN Mo;LAI Youqing;YANG Jing;YANG Yang(Department of Otolaryngology,Beijing Jishuitan Hospital,Capital Medical University,Beijing,102200,China)

机构地区：[1]首都医科大学附属北京积水潭医院耳鼻咽喉科,北京102200

出　　处：《中国耳鼻咽喉头颈外科》2023年第9期584-588,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析以鼻腔阻塞为主的鼾症患者的临床特征。方法选取来北京积水潭医院耳鼻咽喉科就诊的72例以鼻腔阻塞为主的鼾症患者作为鼻阻塞组,同时选取58例无鼻阻塞因素的患者作为无鼻阻塞组,将鼻阻塞组患者根据呼吸暂停低通气指数(AHI)大小分为单纯鼾症组(AHI<5次/h)、轻度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)组(5次/h≤AHI≤15次/h)、中重度OSAHS组(AHI>15次/h),记录患者一般情况,统计临床检测结果,包括多导睡眠监测(PSG),鼻阻塞症状评分(nasalobstruction symptom evaluation,Nose),鼻声反射、鼻阻力、鼻内镜检查等,统计各组间PSG结果和鼻阻塞因素的差异及鼻阻塞组患者PSG指标与鼻阻塞因素之间的相关性。结果鼻阻塞组和无鼻阻塞组患者在AHI、最低血氧饱和度(lowest oxygen saturation,LSaO_(2))、Nose评分、鼻腔吸气总阻力(total inspiration resistance,TRins)、0~5 cm单侧鼻腔容积(unilateral nasal volume0~5,UV5)、单侧最小截面积(unilateral minimum cross-sectional area,UMCA)之间的差异比较具有统计学意义(P<0.05)。单纯鼾症组、轻度OSAHS组、中重度OSAHS组之间在LSaO_(2)的差异比较有统计学意义(P<0.05),而在Nose评分、TRins、UV5、UMCA之间的差异不具有统计学意义(P>0.05)。鼻阻塞组患者的AHI与LSaO_(2)(r=-0.696,P<0.01)、UMCA(r=-0.246,P=0.037)呈负相关,与Nose评分、TRins、UV5之间无明显相关性,LSaO_(2)与各鼻阻塞指标无明显相关性。结论鼻阻塞组患者的AHI高于无鼻阻塞组,LSaO_(2)低于无鼻阻塞组,鼻阻塞组患者的AHI与LSaO_(2)、UMCA具有一定的相关性。鼻阻塞因素在以鼻腔阻塞为主的鼾症患者的发病中具有重要作用,对于鼻腔阻塞因素的评估受多方面因素的影响,选择鼻部手术适应证,应该综合考虑患者的主客观指标,并结合患者的意愿考虑。OBJECTIVE To analyze the clinical characteristics of snoring patients with nasal obstruction as the main factor.METHODS A total of 72 patients with snoring mainly caused by nasal obstruction were selected as the nasal obstruction group and 58 patients without nasal obstruction factors were selected as the group without nasal obstruction.According to the apnea hypopnea index(AHI),the nasal obstruction group were divided into only snoring group(AHI<5 times/h),mild obstructive sleep apnea hypopnea syndrome(OSAHS)group(5 times/h≤AHI≤15 times/h),moderate and severe OSAHS group(AHI>15 times/h).General information and clinical results of patients was recorded,including polysomnography(PSG),nasal obstruction symptom evaluation(Nose),acoustic rhinometry,rhinomanometry,nasal endoscopy,etc.The differences of PSG results and nasal obstruction factors among the groups and the correlation between PSG indicators and nasal obstruction factors in the nasal obstruction group were analyzed.RESULTS There were statistically significant differences in AHI,lowest oxygen saturation(LSaO_(2)),Nose score,total inspiration resistance(TRins),unilateral nasal volume 0~5(UV5),and unilateral minimum cross-sectional area(UMCA)between patients with and without nasal obstruction(P<0.05).There were statistically significant differences in LSaO_(2) among simple snoring group,mild OSAHS group and moderate to severe OSAHS group(P<0.05),while the differences among Nose score,TRins,UV5,and UMCA were not statistically significant(P>0.05).AHI in nasal obstruction group was negatively correlated with LSaO_(2)(r=-0.696,P<0.01)and UMCA(r=-0.246,P=0.037),and had no significant correlation with Nose score,TRins and UV5,while LSaO_(2) had no significant correlation with various nasal obstruction indexes.CONCLUSIONAHI in patients with nasal obstruction was higher than that in the group without nasal obstruction,and LSaO_(2) was lower than that in the group without nasal obstruction.AHI in patients with nasal obstruction had a certain correlation with LSaO_(

关 键 词：打鼾 睡眠呼吸暂停 阻塞性 鼻腔阻塞 呼吸暂停低通气指数 

分 类 号：R766[医药卫生—耳鼻咽喉科]