Wang Xiao-Ye, Han De-Min, Ye Jing-Ying
Department of Otorhinolaryngology Head and Neck Surgery, Third Affiliated Hospital of Suzhou University, Changzhou 213000, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008 Mar;43(3):163-8.
To study the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and nocturnal laryngopharyngeal reflux (LPR), and discuss the possible mechanism.
Nineteen OSAHS patients had PSG, nocturnal pH and intraesophageal pressure monitoring simultaneously. The sleep stage, body position and pressure change were recorded during every reflux event The relationship between obstructive sleep apnea (OSA) and LPR was analyzed.
Among 19 OSAHS patients, 6 cases were found to have LPR, and 63 reflux events were recorded. There was a negative relationship between the severity of OSAHS and nocturnal mean laryngopharyngeal pH value, but relationship between OSA and reflux events is not statistically significant. The intraesophageal pressure (t = 3.211, P = 0. 007) and upper esophageal sphincter (UES) pressure (t = 2.234, P = 0.046) were statistically different between the patients with and without LPR. There was a positive relationship between the mean value of intraesophageal pressure and the whole night mean laryngopharyngeal pH value (r = 0.592, P = 0.033).
There was significant relationship between severity of OSAHS and nocturnal laryngopharyngeal pH value. OSAHS patients are more likely to have esophageal reflux which could increase LPR, Compared with OSAHS patients without LPR, UES pressure during the night decreased significantly in those cases with LPR, it suggested this could be another mechanism of LPR.
研究阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与夜间喉咽反流(LPR)之间的关系,并探讨其可能机制。
19例OSAHS患者同时进行多导睡眠图(PSG)、夜间pH值及食管内压力监测。记录每次反流事件时的睡眠阶段、体位及压力变化,分析阻塞性睡眠呼吸暂停(OSA)与LPR之间的关系。
19例OSAHS患者中,6例存在LPR,共记录到63次反流事件。OSAHS严重程度与夜间喉咽平均pH值呈负相关,但OSA与反流事件之间的关系无统计学意义。有LPR与无LPR患者的食管内压力(t = 3.211,P = 0.007)及食管上括约肌(UES)压力(t = 2.234,P = 0.046)存在统计学差异。食管内压力平均值与全夜喉咽平均pH值呈正相关(r = 0.592,P = 0.033)。
OSAHS严重程度与夜间喉咽pH值之间存在显著关系。OSAHS患者更易发生食管反流,从而增加LPR。与无LPR的OSAHS患者相比,有LPR的患者夜间UES压力显著降低,提示这可能是LPR的另一种机制。