Biomedical Science and Human Oncology, Internal Medicine V, University of Torino, Torino, Italy.
Respir Med. 2010 Feb;104(2):316-20. doi: 10.1016/j.rmed.2009.09.020. Epub 2009 Oct 23.
Hypoxia and snoring-related mechanical trauma contribute to airway inflammation in obstructive sleep apnoea (OSA). Increased exhaled nitric oxide (FENO), an airway inflammation marker, has been reported in OSA patients. We propose the measure of NO in the oral cavity (oNO) as marker of oropharyngeal inflammation in OSA.
We compared oNO and FENO of 39 OSA patients with those of 26 mild asthmatics (ASTHMA), 15 patients with chronic rhinitis or rhinosinusitis (CRS) and 24 healthy subjects. A special device was used for oNO measurement. Apnoea/hypopnoea index (AHI), oxygen desaturation index, mean and nadir SaO2 were calculated from the polysomnography.
oNO was significantly increased in OSA (104.2 95%CI 80.2-135.5ppb) as compared to ASTHMA (71.9 95%CI 56.3-91.9ppb; p=0.015), CRS (54.4 95%CI 40.2-73.7ppb; p=0.009) and healthy subjects (63.6 95%CI 59-73ppb; p<0.001). oNO was directly related to AHI (r=0.466, p=0.003) and to minutes slept with SaO2 <90% (r=0.471, p=0.011) and it was inversely related to nadirSaO2 (r=-0.393, p=0.018). FENO was highest in asthmatics (40.3 95%CI 32.5-50.1ppb) and only slightly elevated in OSA (23.1 95%CI 19,8-28.3ppb) and CRS (22.8 95%CI 16.8-32.5ppb).
The finding that oral NO is increased in OSA and is related to upper airway obstructive episodes and to hypoxemia severity, strengthens the clinical and pathogenic role of oral inflammation in OSA.
缺氧和与打鼾相关的机械创伤导致阻塞性睡眠呼吸暂停（OSA）中的气道炎症。已经报道，在 OSA 患者中，呼出的一氧化氮（FENO）增加，这是一种气道炎症标志物。我们提出将口腔中的一氧化氮（oNO）作为 OSA 口咽炎症的标志物。
我们比较了 39 例 OSA 患者、26 例轻度哮喘患者（ASTHMA）、15 例慢性鼻炎或鼻-鼻窦炎患者（CRS）和 24 例健康受试者的 oNO 和 FENO。使用特殊设备测量 oNO。从多导睡眠图中计算出呼吸暂停/低通气指数（AHI）、氧减饱和度指数、平均和最低 SaO2。
与 ASTHMA（71.9 95%CI 56.3-91.9ppb；p=0.015）、CRS（54.4 95%CI 40.2-73.7ppb；p=0.009）和健康受试者（63.6 95%CI 59-73ppb；p<0.001）相比，OSA 患者的 oNO 明显升高（104.2 95%CI 80.2-135.5ppb）。oNO 与 AHI 直接相关（r=0.466，p=0.003），与睡眠期间 SaO2<90%的时间相关（r=0.471，p=0.011），与最低 SaO2 呈负相关（r=-0.393，p=0.018）。哮喘患者的 FENO 最高（40.3 95%CI 32.5-50.1ppb），OSA 患者和 CRS 患者的 FENO 略高（分别为 23.1 95%CI 19，8-28.3ppb 和 22.8 95%CI 16.8-32.5ppb）。
口腔 NO 在 OSA 中增加，并与上气道阻塞发作和低氧血症严重程度相关，这加强了口腔炎症在 OSA 中的临床和发病作用。
