天津医药

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重度 OSAHS患者鼻通气功能状态的研究

肖彩霞1,鲁宏华2,阮宏莹3,林鹏1   

  1. 1. 天津医科大学一中心临床学院
    2. 天津市第一中心医院耳鼻咽喉头颈外科，天津市耳鼻喉科研究所
    3. 天津市第一中心医院
  • 收稿日期:2012-10-29 修回日期:2013-02-04 出版日期:2013-06-15 发布日期:2013-06-15
  • 通讯作者: 肖彩霞

Study of Nasal Ventilatory Function in Patients with Severe Obstructive Sleep Apnea Hypopnea Syndrome

XIAO Caixia1 1,LU Honghua 2,RUAN Hongying 2,LIN Peng 3   

  1. 1. The First Center Clinic College of Tianjin Medical University, Tianjin 300192, China
    2. Department of Otorhinolaryngology Head and Neck Surgery, Tianjin First Central Hospital；Otorhinolaryngology Institute of Tianjin
    3. The First Center Clinic College, Tianjin Medical University
  • Received:2012-10-29 Revised:2013-02-04 Published:2013-06-15 Online:2013-06-15
  • Contact: XIAO Caixia1

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摘要： 【摘要】 目的 评估无鼻阻塞亦无明显鼻腔结构异常的重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的鼻通气功能状态。 方法 102 例健康正常人为对照组， 77 例无鼻阻塞亦无明显鼻腔结构异常的重度 OSAHS 为观察组。 应用鼻声反射、鼻阻力及鼻呼吸量测量法测量 2 组鼻通气功能， 测量指标包括鼻腔最小截面积(MCA)、鼻腔最小截面积距前鼻孔距离(DCAN)、鼻腔 0～ 5 cm容积(V5)、2～ 5 cm容积(V2~5)； 单侧鼻腔吸气阻力(IR)、呼气阻力(ER)、计算双侧吸气总阻力(TIR)、双侧鼻腔呼气总阻力(TER)； 双侧鼻腔吸气量(IC)、呼气量(EC)、鼻呼吸量差异比(NPR)[包括吸气量差异比 (NPRi)及呼气量差异比(NPRe)]； 将 2 组间参数进行比较。 结果 与正常组比较， 观察组 IR、ER、TIR、TER、IC、EC、NPRi、NPRe 均增大； V5、V2~5均减小(P < 0.05 或 P＜ 0.01)。 结论 无鼻阻塞亦无明显鼻腔结构异常的重度 OSAHS患者鼻通气功能存在异常,OSAHS患者咽部阻塞可以引起鼻通气功能的变化。

关键词: 睡眠呼吸暂停, 阻塞性, 睡眠呼吸暂停综合征, 鼻测量, 声学, 鼻腔测压, 鼻, 炎症

Abstract: Abstract   Objective   TO study the nasal ventilatory function of severe obstructive sleep apnea hypopnea syndrome(OSAHS) patients without nasal obstruction and nasal anatomy anomalies. Methods    102 healthy controls and 77 patients with severe OSAHS without nasal obstruction and nasal anatomy anomalies were included in this study. Acoustic rhinometry was used to measure the minimum cross-sectional area(MCA),distance of the minimal cross-sectional area to the nostril(DCAN) and the nasal volume from 0 to 5cm,2 to 5cm(V5, V2-5). Rhinomanometry was used to measure unilateral nasal inspiratory resistance (IR) and expiratory resistance (ER) at 150 pa,total bilateral inspiratory resistance(TIR) and total bilateral expiratory resistance(TER) were obtained by calculation. Rhinospirometer was used to measure unilateral inspiratory capacity(IC) and expiratory capacity(EC),and the nasal partitioning ratio(NPR) can be calculated. Results     Compared to control group, IR,ER,TIR, TER, IC, EC, NRPi and NRPe were all significantly higher (P<0.05) while V5 and V2~5 were significantly lower(P<0.05) in the OSAHS group. Conclusion     Nasal ventilatory function is abnormal in the severe OSAHS patients without nasal obstruction and nasal anatomy anomalies; pharyngeal obstruction in the OSAHS could cause the change in the nasal ventilatory function.

Key words: Sleep apnea hypopnea, obstructive, sleep apnea syndromes, rhinometry, acoustic, rhinomanometry, nose, 炎症