鼻通气功能评估在睡眠呼吸紊乱疾病中的应用价值

发布时间：2018-01-17 02:10

本文关键词：鼻通气功能评估在睡眠呼吸紊乱疾病中的应用价值　出处：《临床耳鼻咽喉头颈外科杂志》2014年15期 　论文类型：期刊论文

【摘要】：目的:探讨睡眠呼吸紊乱(SDB)人群中鼻腔通气功能的改变及鼻通气功能的各项指标与PSG监测指标的相关性。方法:利用NV1鼻呼吸量仪测量128例正常人、11例习惯性打鼾患者和33例轻中度OSAHS和33例重度OSAHS的单侧鼻腔总呼吸量(NCun)、双侧鼻腔总呼吸量(NCbi)和鼻呼吸流量差异比(NPR,包括吸气量差异比NPRi和呼气量差异比NPRe);利用NR6鼻阻力仪测量受试者的双侧鼻腔吸气相的总阻力(TNRi)和双侧鼻腔呼气相的总阻力(TNRe);利用A1鼻声反射仪测量受试者的第一切迹距离前鼻孔的距离(MD1)及横截面积(MCA1)、第二切迹距离前鼻孔的距离(MD2)与横截面积(MCA2)及鼻腔0~5cm段的容积(NV0-5)。将鼻通气功能的各项指标与PSG结果进行相关研究。结果:①鼻呼吸量参考值NPR的组间差异有统计学意义(P0.01),而NCbi及NCun无组间差异。②TNRi和TNRe的组间差异均有统计学意义(P0.01或P0.05),其中正常对照组与轻中度OSAHS组的TNRi差异有统计学意义(P0.01);对照组与重度OSAHS组的TNRi和TNRe均差异有统计学意义(均P0.01)。③男性患者的MD1、MCA1、MCA2、NV0-5参数有显著的组间差异(均P0.05);但在女性患者中,MCA1、MD2、MCA2和NV0-5均无组间差异。④在SDB人群中,PSG各指标与鼻通气功能指标均无相关性。将BMI进行分级(25;25~35;35),发现BMI25的女性患者中最低血氧饱和度与MCA2呈正相关(r=0.688,P0.05),微觉醒指数与MCA1呈负相关(r=-0.543,P0.05);而男性人群中各指标仍无相关性。结论:鼻腔解剖结构和生理功能的改变与SDB发病有关,而鼻腔阻塞对SDB疾病的作用在非肥胖女性患者中较肥胖患者更为显著。
[Abstract]:Objective: To investigate the relationship between sleep disordered breathing (SDB) and the indexes of PSG monitoring index changes and the nasal ventilation function of nasal ventilation in the crowd. Methods: using NV1 nasal breathing measuring instrument in 128 normal cases, 11 cases of habitual snoring patients and 33 patients with mild to moderate OSAHS and 33 cases of severe unilateral nasal OSAHS total respiration (NCun), bilateral nasal total respiration (NCbi) and nasal breathing flow difference than (NPR, including NPRi and inspiratory volume differences than expiratory volume differences than NPRe); the total resistance test using NR6 for measuring the bilateral nasal resistance and nasal inspiratory phase (TNRi) and bilateral nasal expiratory resistance the use of A1 (TNRe); acoustic rhinometry measurement of the subjects of the first notch distance anterior nostril distance (MD1) and cross-sectional area (MCA1), second of distance anterior nostril distance (MD2) and the cross sectional area (MCA2) and the volume of nasal 0~5cm segment (NV0-5). The nose ventilation function The PSG index and the related research results. Results: the nasal respiration reference value were statistically significant between group NPR (P0.01), but there was no difference between groups NCbi and NCun, TNRi and TNRe. The differences between groups were statistically significant (P0.01 or P0.05), including normal control group with mild to moderate TNRi difference the OSAHS group had statistical significance (P0.01); control group showed significant and severe OSAHS group TNRi and TNRe respectively (P0.01). The male patients with MD1, MCA1, MCA2, NV0-5 parameters have a significant difference between the groups (P0.05); but in female patients, MCA1, MD2, were there was no difference between groups MCA2 and NV0-5. In the SDB population, there was no correlation between PSG indexes and nasal ventilation function index. The BMI classification (25; 25~35; 35), found that women with BMI25 in the lowest oxygen saturation was positively correlated with MCA2 (r=0.688, P0.05), arousal index and MCA1 is negative related (r=-0.543, P0.05 There was no correlation between the indexes in male population. Conclusion: the change of nasal cavity anatomical structure and physiological function is related to the onset of SDB, while the effect of nasal obstruction on SDB disease is more significant in obese women than in obese patients.

【作者单位】：广州医科大学附属第二医院耳鼻咽喉科;
【分类号】：R766
【正文快照】： 睡眠呼吸紊乱(sleep-disordered breathing,SDB)是指睡眠时呼吸节律及幅度异常的一组疾病,包括习惯性打鼾、上气道阻力综合征(upper air-way resistance syndrome,UARS)、阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea-hy-popnea syndrome,OSAHS)。男性发病率约24%

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