鼻腔阻力增加在肥胖阻塞性睡眠呼吸暂停综合征患者中的发病机制作用。

Pathogenetic role of increased nasal resistance in obese patients with obstructive sleep apnea syndrome.

机构信息

Department of Otorhinolaryngology, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.

出版信息

Am J Rhinol Allergy. 2010 Jan-Feb;24(1):51-4. doi: 10.2500/ajra.2010.24.3382.

DOI:10.2500/ajra.2010.24.3382

PMID:20109326

Abstract

BACKGROUND

The role of increased nasal resistance in obstructive sleep apnea syndrome (OSAS) remains controversial. The aim of this study was to examine the pathogenetic role of nasal obstruction in obese patients with OSAS.

METHODS

Patients with OSAS (n = 125) at a university hospital were divided into three groups according to body mass index (BMI): nonobese (BMI < 25 kg/m(2)), mildly obese (25 kg/m(2) < or = BMI < 30 kg/m(2)), and obese (BMI > or = 30 kg/m(2)). The subjects underwent nasopharyngoscopy, measurement of nasal resistance, and polysomnography.

RESULTS

We studied 42 nonobese, 47 mildly obese, and 36 obese patients with OSAS. Among the obese, but not the nonobese and mildly obese patients, we found significant correlations between the oxygen desaturation index (ODI) and bilateral nasal resistance (BNR; r = 0.412; p = 0.013), between the ODI and unilateral higher nasal resistance (UHNR; r = 0.413; p = 0.012), and between the apnea index and UHNR (r = 0.334; p = 0.046). Multiple regression analysis incorporating all patients showed that BMI (p < 0.001) and BNR (p = 0.033) were independently related to the ODI.

CONCLUSION

In obese patients with OSAS, increased nasal resistance could play an important pathogenetic role in hypoxemic apnea.

摘要

背景

鼻腔阻力增加在阻塞性睡眠呼吸暂停综合征（OSAS）中的作用仍存在争议。本研究旨在探讨肥胖的 OSAS 患者中鼻腔阻塞的发病机制作用。

方法

根据体重指数（BMI）将大学医院的 125 例 OSAS 患者分为三组：非肥胖组（BMI < 25 kg/m²）、轻度肥胖组（25 kg/m² ≤ BMI < 30 kg/m²）和肥胖组（BMI ≥ 30 kg/m²）。所有患者均接受鼻咽镜检查、鼻腔阻力测量和多导睡眠图检查。

结果

我们研究了 42 例非肥胖、47 例轻度肥胖和 36 例肥胖的 OSAS 患者。在肥胖患者中，但在非肥胖和轻度肥胖患者中，我们发现低氧饱和度指数（ODI）与双侧鼻腔阻力（BNR；r = 0.412；p = 0.013）、ODI 与单侧高鼻腔阻力（UHNR；r = 0.413；p = 0.012）以及呼吸暂停指数与 UHNR 之间（r = 0.334；p = 0.046）存在显著相关性。纳入所有患者的多元回归分析显示，BMI（p < 0.001）和 BNR（p = 0.033）与 ODI 独立相关。