重度阻塞性睡眠呼吸暂停患者悬雍垂腭咽成形术前后前庭功能和BMI的变化  

Changes in vestibular function and BMI before and after UPPP in patients with severe OSA

作　　者：王婧 史雅文[1] 殷敏[1] WANG Jing;SHI Yawen;YIN Min(Department of Otorhinolaryngology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院耳鼻咽喉科,南京210029

出　　处：《医学研究与战创伤救治》2024年第10期1071-1074,共4页Journal of Medical Research & Combat Trauma Care

摘　　要：目的研究阻塞性睡眠呼吸暂停(OSA)患者呼吸暂停低通气指数(AHI)与Epworth睡眠量表(ESS)评分之间的相关性;探讨悬雍垂腭咽成形术(UPPP)对OSA患者BMI、前庭功能和嗜睡程度是否具有改善作用。方法选取2022年10月至2023年11月于南京医科大学第一附属医院耳鼻咽喉科因OSA就诊并接受UPPP治疗的28例患者。所有患者进行整夜睡眠多导图检查,分析AHI与ESS评分之间的相关性;评估手术前后颈源性前庭诱发肌源性电位(cVEMP)的检查结果和BMI以及ESS评分的改善情况。结果OSA患者的AHI与ESS评分具有相关性(r=0.448,P=0.017)。OSA患者术后BMI、ESS评分较术前明显下降(P=0.014、P<0.000)。术后OSA患者引出率显著高于术前(P<0.000)。术后cVEMP的P1潜伏期、N1潜伏期较术前明显降低(P<0.05)。与术前比较,OSA患者术后P1潜伏期、N1潜伏期和P1-N1振幅的不对称率均下降(P<0.05)。结论OSA患者ESS评分与呼吸暂停严重程度有关,UPPP能够改善OSA患者的前庭功能和BMI,减轻患者嗜睡程度。Objective To study the correlation between the apnea hypopnea index(AHI)and Epworth Sleepiness Scale(ESS)scores in obstructive sleep apnea(OSA)patients as well as investigate the treating effect of uvulopalatopharyngoplasty(UPPP)on the body mass index(BMI),vestibular function and degree of sleepiness in OSA patients.Methods Twenty-eight patients with severe OSA who received UPPP were selected in the Department of Otorhinolaryngology,the First Affiliated Hospital of Nanjing Medical University from October 2022 to November 2023.Polysomnography(PSG)was performed to analyze the correlation between AHI and ESS scores.The results of cervical vestibular myogenic evoked potential(cVEMP),the improvement of BMI and ESS score before and after surgery were also evaluated.Results There was a correlation between AHI and ESS score in OSA patients(r=0.448,P=0.017).The BMI and ESS scores of OSA patients were significantly lower than those before surgery(P=0.014,P<0.000).The presence rate of OSA patients after operation was significantly higher than that before operation(P<0.000).The P1 latency and N1 latency of cVEMP were significantly decreased after operation(P<0.05).The asymmetry rate of P1 latency,N1 latency and P1-N1 amplitude in OSA patients after surgery were significantly lower than those before surgery(P<0.05).Conclusion The ESS score of OSA patients is related to the severity of OSA.UPPP can improve the vestibular function of OSA patients,and reduce the BMI and the degree of sleepiness.

关 键 词：阻塞性睡眠呼吸暂停 悬雍垂腭咽成形术 颈源性前庭诱发肌源性电位 前庭功能 

分 类 号：R766.4[医药卫生—耳鼻咽喉科]