1500例阻塞性睡眠呼吸暂停低通气综合征患者鼻阻塞性病变分析

目的：探讨鼻阻塞对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrome，OSAHS）发病的影响。方法：回顾分析经多导睡眠图（polysomnography，PSG）监测确诊的1500例OS—AHS患者应用纤维鼻咽喉镜及电视摄像系统检查鼻阻塞性病变的发生情况；以及伴有鼻阻塞与不伴有鼻阻塞的OSAHS患者的PSG主要检测指标的差异。结果：1500例OSAHS患者中有各种鼻阻塞性病变者855例，其中鼻中隔偏曲及棘状突和嵴状突733例，单纯下鼻甲肥厚98例，鼻息肉24例。各种鼻阻塞性病变发生率明显高于无睡眠打鼾及呼吸暂停的健康对照（P〈0．01）。伴有鼻阻塞与不伴鼻阻塞的两组OSAHS患者之间和鼾声指数差异有统计学意义（P〈0．01）。而呼吸暂停低通气指数（apnea hypopnea index，AHI）、最低血氧饱和度和微觉醒指数两纽之间差异无统计学意义（P〉0.05）。结论：鼻阻塞可能在0SAHS发病中起一定作用；但鼻阻塞不是引起OSAHS的主要因素，而是合作因素。

Analysis of nasal obstruction in 1500 patients with obstructive sleep apnea hypopnea syndrome

Objective: To evaluate the role of nasal obstruction disorders in the process of obstructive sleep apnea hypopnea syndrome(OSAHS).Methods: The prevalence of the nasal anatomical stricture was determined by using flexible fiberoptic endoscope and video recorder equipment in 1?500 patients with OSAHS.The results of nocturnal polysomnography were analyzed in the patients with and without nasal obstruction.Results: Nasal obstructive disorder was found in 855 patients,of whom 733 were with septal deviation,98 with inferior turbinate hypertrophy and 24 with nasal polyps.The morbidity of nasal obstructive disorder in patients with OSAHS was significant higher than in the healthy controls without snoring and sleep apnea(P<0.01).The snoring index was significantly different between the OSAHS patients with and without nasal obstruction(P<0.01),whereas the apnea hypopnea index(AHI),lowest oxygen saturation levels and the microarousal index were not significantly different between the two groups(P>0.05).Conclusion: Nasal obstruction may contribute to the pathogenesis of OSAHS,while it is not a main factor for OSAHS but a co-factor for OSAHS during sleep.