天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (9): 1015-1018.doi: 10.11958/j.issn.0253-9896.2015.09.016

• 临床研究 • 上一篇    下一篇

变应性和非变应性鼻炎与阻塞性睡眠呼吸暂停低通气综合征的关系

张良   

  1. 天津市公安医院耳鼻咽喉科 （邮编300050）
  • 收稿日期:2014-10-11 修回日期:2015-05-15 出版日期:2015-09-15 发布日期:2015-09-15
  • 通讯作者: 张良 E-mail:zltjyy123@163.com
  • 作者简介:张良 （1961）， 男， 大学本科， 副主任医师， 主要从事耳鼻咽喉鼻部疾病研究

The relationship between allergic, non-allergic rhinitis and obstructive sleep#br# apnea-hypopnea syndrome

ZHANG Liang   

  1. Department of Otolaryngology, Tianjin Gongan Hospital, Tianjin 300050, China
  • Received:2014-10-11 Revised:2015-05-15 Published:2015-09-15 Online:2015-09-15

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摘要： 目的 探讨变应性鼻炎 （AR） 和非变应性鼻炎 （NAR） 与阻塞性睡眠呼吸暂停低通气综合征 （OSAHS） 的关系。方法 就诊于我院门诊的 48 例患者， 均具有 2 年以上 AR 症状和睡眠打鼾症状， 均行皮肤点刺试验、 血清特异性免疫球蛋白 （Ig） E 检测、 多导睡眠监测 （PSG）、 鼻声反射、 鼻阻力 （RM） 测量、 Müller′s 试验 （FPMM） 和 Epworth 嗜睡量表 （ESS） 评分。结果 AR 患者 25 例， NAR 23 例。ESS>9 分患者 19 例， 其中 NAR15 例， AR4 例， NAR 组嗜睡发生率高于 AR 组 （P < 0.05）。PSG 结果显示， NAR 组患者呼吸暂停比例较大、 患者睡眠效率较差、 AHI 指数较高、 最低血氧饱和度 （LSpO2 ） 和平均血氧饱和度 （ASpO2 ） 较低 （P < 0.05）， NAR 组患者 OSAHS 发生率明显高于 AR 组 （82.6% vs 36.0%）。MAR 组收缩后鼻腔最小横截面积 （NMCA）、 鼻腔容积 （MCV） 均小于 AR 组， RM 高于 AR 组； NAR 组腭咽、舌咽平面狭窄阻塞发生率高于 AR 组 （P < 0.05）。结论 AR 和 NAR 均为 OSAHS 致病的危险因素， 均可诱发睡眠障碍。NAR 患者更易导致OSAHS， 且严重程度较高， NAR 对OSAHS 的发生可能存在重要的启动作用。

关键词: 鼻炎, 变应性, 季节性, 睡眠呼吸暂停, 阻塞性, 变应性鼻炎, 非变应性鼻炎, 阻塞性睡眠呼吸暂停低通气综合征

Abstract: Objective To investigate the relationship between allergic rhinitis (AR), non-allergic rhinitis (NAR) and obstructive sleep apnea- hypopnea syndrome (OSAHS). Methods Forty- eight patients with AR symptoms and snoring symptoms for at least 2 years, who received treatment in our outpatient, were included in this study. Skin prick test, serum specific IgE, polysomnography (PSG), acoustic rhinometry, nasal resistance (RM), Müller's test (FPMM) and Epworth sleepi⁃ ness scale (ESS) were performed in patients. Results There were 25 AR patients (AR group) and 23 NAR cases (NAR group). ESS> 9 scores were found in 19 patients, including 15 NAR cases and 4 AR cases. There was higher incidence of drowsiness in NAR group than that of AR group (P < 0.05). Results of PSG showed that there were significantly higher proportions of apnea, poor sleep quality, AHI index, and lower values of the lowest oxygen saturation (LSpO2) and mean oxygen saturation (ASpO2) in NAR group than those of AR group (P < 0.05). The incidence of OSAHS was significantly higher in NAR group than that of AR group (82.6% vs 36.0%, P < 0.05). Conclusion Both AR and NAR were risk factors for OSAHS, and both can induce sleep disorders. NAR patients were more likely to result in OSAHS, and showing higher disease severity. NAR may have an important role in the initiation of OSAHS.

Key words: rhinitis, allergic, seasonal, sleep apnea, obstructive, allergic rhinitis, nonallergic rhinitis, obstructive sleep
apnea hypopnea syndrome