肥胖对重度阻塞性睡眠呼吸暂停患者悬雍垂腭咽成形术成功率的影响：台湾一项单中心回顾性研究
Impact of obesity on uvulopalatopharyngoplasty success in patients with severe obstructive sleep apnea: a retrospective single-center study in Taiwan.
作者信息
Shie Dung-Yun, Tsou Yung-An, Tai Chih-Jaan, Tsai Ming-Hsui
机构信息
Department of Otolaryngology, China Medical University Hospital, Taichung, Taiwan, ROC.
出版信息
Acta Otolaryngol. 2013 Mar;133(3):261-9. doi: 10.3109/00016489.2012.741328. Epub 2013 Jan 8.
CONCLUSION
Our findings suggest that, in Asian patients with severe obstructive sleep apnea (OSA), obesity is a better predictor of uvulopalatopharyngoplasty (UPPP) failure than Friedman stage III.
OBJECTIVES
This study evaluated UPPP success rates in obese and non-obese Asian patients treated for severe OSA.
METHODS
Records of patients who underwent UPPP for treatment of OSA were retrospectively reviewed. Preoperative and postoperative apnea/hypopnea index (AHI) and Epworth Sleepiness Scale (ESS) score, and Friedman stage were compared in non-obese (body mass index (BMI) <27 kg/m(2)) and obese (BMI ≥27 kg/m(2)) patients. Treatment success was defined as >50% reduction in preoperative AHI or postoperative AHI of <20 events/h.
RESULTS
Treatment success was significantly lower (p < 0.0001) in the obese group (24.6%) compared with the non-obese group (62.5%). After adjusting for gender, age, BMI, Friedman stage, and preoperative AHI and ESS score, obesity was a significant independent negative predictor of treatment success (adjusted OR = 0.297, 95% CI = 0.114-0.773, p = 0.013).
结论
我们的研究结果表明，在患有严重阻塞性睡眠呼吸暂停（OSA）的亚洲患者中，肥胖比弗里德曼III期更能预测悬雍垂腭咽成形术（UPPP）的失败。
目的
本研究评估了接受严重OSA治疗的肥胖和非肥胖亚洲患者的UPPP成功率。
方法
回顾性分析接受UPPP治疗OSA患者的记录。比较非肥胖（体重指数（BMI）<27 kg/m²）和肥胖（BMI≥27 kg/m²）患者术前和术后的呼吸暂停/低通气指数（AHI）、爱泼沃斯嗜睡量表（ESS）评分以及弗里德曼分期。治疗成功定义为术前AHI降低>50%或术后AHI<20次/小时。
结果
肥胖组（24.6%）的治疗成功率显著低于非肥胖组（62.5%）（p<0.0001）。在调整性别、年龄、BMI、弗里德曼分期以及术前AHI和ESS评分后，肥胖是治疗成功的显著独立负性预测因素（调整后的OR = 0.297，95%CI = 0.114 - 0.773，p = 0.013）。
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