OSAHS患者肺顺应性与胃食管反流病相关性的研究
发布时间：2018-11-16 11:58
【摘要】：目的:评价OSAHS患者肺顺应性与胃食管反流程度之间的相关性,旨在探讨OSAHS患者发生胃食管反流的可能机制。方法:选取2014年2月至2016年2月期间在新疆维吾尔自治区人民医院耳鼻喉科疑似OSAHS首次入院患者,分别行常规肺功能检查、多导睡眠监测(PSG)、脉冲振荡系统(IOS)、24h多通道阻抗-PH监测系统,制定纳入排除标准,212例疑似患者中,确诊为OSAHS患者117例,非OSAHS患者95例;其中62例OSAHS患者伴有病理性胃食管反流(A组);55例OSAHS患者不伴有病理性胃食管反流(B组);41例非OSAHS患者伴有病理性胃食管反流(C组);54例非OSAHS患者不伴有病理性胃食管反流(D组)。比较组间多导睡眠监测参数、常规肺功能参数、脉冲振荡测定指标、24h多通道阻抗-PH监测参数,并对其做相关分析。结果:A组(OSAHS伴GER)、B组(OSAHS不伴GER)、C组(非OSAHS伴GER)、D组(非OSAHS不伴GER)四组间AHI、LSa02差异有统计学意义(P0.05),而年龄和BMI差异无统计学意义(P0.05);四组间FRC和ERV差异有统计学意义(P0.05),而FVC、FEV1、FEV1/FVC、VC、TLC无显著性差异(P0.05),A组的FRC和ERV低于B、C、D组,差异有统计学意义(P0.05);四组间Zrs5和R5、R10、R15和X5、X10、X15和Fres有差异且有统计学意义(P0.05),而A组与B组间Zrs5和R5、R10、R15和X5和Fres有差异且有统计学意义(P0.05);四组间UES的平均静息压力及残余压力、LES的平均静息压力及残余压力、弱酸反流次数差异均无统计学意义(P0.05);而反流总次数、酸反流次数、De Meester评分差异有统计学意义(P0.05),A组与B组、C组、D组相比,反流总次数、酸反流次数、De Meester评分组间差异均有统计学意义(P0.05)。相关分析显示:OSAHS患者的AHI与R5和R20呈正相关(P0.05);LSa02与R5和R20呈负相关(P0.05);OSAHS患者的Zrs5和R5、R10、R15与反流总次数、De Meester评分呈正相关(P0.05);X5与反流总次数、De Meester评分呈负相关(P0.05)。结论:OSAHS患者呼吸系统力学特征发生改变,呼吸阻力增加和呼吸系统弹性增加,尤其是肺的顺应性下降可能与胃食管反流相关。
[Abstract]:Objective: to evaluate the relationship between gastroesophageal reflux (GER) and lung compliance in patients with OSAHS, and to explore the possible mechanism of gastroesophageal reflux (GER) in OSAHS patients. Methods: from February 2014 to February 2016, suspected OSAHS patients were admitted to the Department of Otorhinolaryngology, Xinjiang Uygur Autonomous region people's Hospital for the first time. Routine pulmonary function tests and polysomnography (PSG), pulse oscillation system (IOS),) were performed respectively. 24 h multi-channel impedance PH monitoring system was established and excluded. 117 cases were diagnosed as OSAHS patients and 95 cases as non-OSAHS patients out of 212 suspected patients. There were 62 cases of OSAHS with pathological gastroesophageal reflux (group A), 55 cases of OSAHS with no pathological gastroesophageal reflux (group B), 41 cases of non-OSAHS patients with pathological gastroesophageal reflux (group C). No pathological gastroesophageal reflux was found in 54 non-OSAHS patients (group D). The parameters of polysomnography, routine pulmonary function, pulse oscillation and 24 hours multichannel impedance-PH monitoring were compared, and the correlation analysis was made. Results: there were significant differences in AHI,LSa02 among four groups in group A (OSAHS with GER), B (OSAHS without GER), C) (non-OSAHS with GER), D) (non-OSAHS without GER) (P0.05), but there was no significant difference in age and BMI (P0.05). There was significant difference in FRC and ERV among the four groups (P0.05), but no significant difference in FVC,FEV1,FEV1/FVC,VC,TLC (P0.05). (P0.05) FRC and ERV in), A group were lower than those in), A group (P0.05). There was significant difference between Zrs5 and R5, R10, R15, X5, X10, X15 and Fres (P0.05), but there was significant difference between group A and group B in Zrs5, R5, R10, R15, X5 and Fres (P0.05). The average rest pressure and residual pressure of UES, the average rest pressure and residual pressure of LES, the times of weak acid reflux were not significantly different among the four groups (P0.05). However, the total number of reflux and the number of acid reflux in, De Meester score were significantly different between), A group and B group, C group and D group (P0.05), the total number of reflux and the number of acid reflux in group D were significantly higher than those in group B, group C and group D, respectively. There were significant differences in De Meester score between groups (P0.05). Correlation analysis showed that AHI was positively correlated with R5 and R20 in OSAHS patients (P0.05), LSa02 was negatively correlated with R5 and R20 (P0.05), Zrs5 and R5R10R15 in); OSAHS patients were positively correlated with, De Meester score of total reflux number (P0.05). X _ 5 was negatively correlated with the total number of reflux, De Meester scores (P 0.05). Conclusion: the mechanical characteristics of respiratory system, respiratory resistance and respiratory elasticity, especially the decrease of lung compliance, may be related to gastroesophageal reflux in patients with OSAHS.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766
[Abstract]:Objective: to evaluate the relationship between gastroesophageal reflux (GER) and lung compliance in patients with OSAHS, and to explore the possible mechanism of gastroesophageal reflux (GER) in OSAHS patients. Methods: from February 2014 to February 2016, suspected OSAHS patients were admitted to the Department of Otorhinolaryngology, Xinjiang Uygur Autonomous region people's Hospital for the first time. Routine pulmonary function tests and polysomnography (PSG), pulse oscillation system (IOS),) were performed respectively. 24 h multi-channel impedance PH monitoring system was established and excluded. 117 cases were diagnosed as OSAHS patients and 95 cases as non-OSAHS patients out of 212 suspected patients. There were 62 cases of OSAHS with pathological gastroesophageal reflux (group A), 55 cases of OSAHS with no pathological gastroesophageal reflux (group B), 41 cases of non-OSAHS patients with pathological gastroesophageal reflux (group C). No pathological gastroesophageal reflux was found in 54 non-OSAHS patients (group D). The parameters of polysomnography, routine pulmonary function, pulse oscillation and 24 hours multichannel impedance-PH monitoring were compared, and the correlation analysis was made. Results: there were significant differences in AHI,LSa02 among four groups in group A (OSAHS with GER), B (OSAHS without GER), C) (non-OSAHS with GER), D) (non-OSAHS without GER) (P0.05), but there was no significant difference in age and BMI (P0.05). There was significant difference in FRC and ERV among the four groups (P0.05), but no significant difference in FVC,FEV1,FEV1/FVC,VC,TLC (P0.05). (P0.05) FRC and ERV in), A group were lower than those in), A group (P0.05). There was significant difference between Zrs5 and R5, R10, R15, X5, X10, X15 and Fres (P0.05), but there was significant difference between group A and group B in Zrs5, R5, R10, R15, X5 and Fres (P0.05). The average rest pressure and residual pressure of UES, the average rest pressure and residual pressure of LES, the times of weak acid reflux were not significantly different among the four groups (P0.05). However, the total number of reflux and the number of acid reflux in, De Meester score were significantly different between), A group and B group, C group and D group (P0.05), the total number of reflux and the number of acid reflux in group D were significantly higher than those in group B, group C and group D, respectively. There were significant differences in De Meester score between groups (P0.05). Correlation analysis showed that AHI was positively correlated with R5 and R20 in OSAHS patients (P0.05), LSa02 was negatively correlated with R5 and R20 (P0.05), Zrs5 and R5R10R15 in); OSAHS patients were positively correlated with, De Meester score of total reflux number (P0.05). X _ 5 was negatively correlated with the total number of reflux, De Meester scores (P 0.05). Conclusion: the mechanical characteristics of respiratory system, respiratory resistance and respiratory elasticity, especially the decrease of lung compliance, may be related to gastroesophageal reflux in patients with OSAHS.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R766
【参考文献】
相关期刊论文 前10条
1 张赛;尤乐都斯;;食管动力和反流事件在OSAHS发病机制中意义[J];中华胃食管反流病电子杂志;2014年01期
2 曲s，
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