重度 OSAHS患者鼻通气功能状态的研究

【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。

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

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.