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阻塞性睡眠呼吸暂停低通气综合征与胃食管反流病之间的相关性

[Correlation between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease].

作者信息

Qu Yue, Ye Jing-ying, Zheng Li, Zhang Yu-huan

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otorhinolaryngology Head and Neck Surgery (Capital Medical University), Ministry of Education, Beijing 100730, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Nov;47(11):899-903.

Abstract

OBJECTIVE

To discuss the occurrence correlation between obstructive sleep apnea hypopnea syndrome (OSAHS) and gastroesophageal reflux disease (GERD).

METHODS

Forty-three patients suspected of laryngopharyngeal reflux disease underwent combined multichannel intraluminal impedance and esophageal manometry (MII-EM), twenty-four-hour esophageal and pharyngeal pH and impedance monitoring and PSG. Subjects were grouped according to the detections. The difference of the measurement between groups were Compared. The possible relationship between the two diseases was analyzed.

RESULTS

Fourteen of all the subjects can be diagnosed to have GERD (32.6%). Twenty-six can be diagnosed to have OSAHS (60.5%). There were 10 patients had OSAHS and GERD simultaneously, which took over 38.5% of the OSAHS group, and 71.4% of the GERD group. BMI (P = 0.000) and lower esophageal sphincter (LES) residual pressure (P = 0.021) were significantly different among the four groups OSAHS, GERD, OSAHS and GERD, and control (non-OSAHS and non-GERD), but no linear relationship between LES residual pressure and prevalence or severity of the two diseases was found. In OSAHS group, AHI were positively correlated with the following indictors: the DeMeester score (r = 0.45), acid exposure of the distal esophagus (r = 0.491). There seems to be no Linear correlation among reflux indicators, sleep indicators, and esophageal functional indicators in GERD group. Linear correlation was not found among reflux indicators, sleep indicators, and esophageal functional indicators in OSAHS and GERD group (P > 0.05).

CONCLUSIONS

The incidence and the severity of GERD and OSAHS were related to each other. Reflux events may aggravate OSAHS. The two diseases may have some relationship on the esophageal function, especially on the regulation of the LES pressure.

摘要

目的

探讨阻塞性睡眠呼吸暂停低通气综合征(OSAHS)与胃食管反流病(GERD)的发生相关性。

方法

对43例疑似咽喉反流病患者进行多通道腔内阻抗与食管测压联合检查(MII-EM)、24小时食管和咽部pH及阻抗监测以及多导睡眠图(PSG)检查。根据检测结果对受试者进行分组,比较组间测量差异,分析两种疾病之间可能的关系。

结果

所有受试者中14例可诊断为GERD(32.6%),26例可诊断为OSAHS(60.5%)。有10例患者同时患有OSAHS和GERD,占OSAHS组的38.5%以上,GERD组的71.4%。OSAHS组、GERD组、OSAHS合并GERD组和对照组(非OSAHS和非GERD)的体重指数(P = 0.000)和食管下括约肌(LES)残余压力(P = 0.021)有显著差异,但未发现LES残余压力与两种疾病的患病率或严重程度之间存在线性关系。在OSAHS组中,呼吸暂停低通气指数(AHI)与以下指标呈正相关:DeMeester评分(r = 0.45)、食管远端酸暴露(r = 0.491)。GERD组的反流指标、睡眠指标和食管功能指标之间似乎不存在线性相关性。OSAHS合并GERD组的反流指标、睡眠指标和食管功能指标之间也未发现线性相关性(P > 0.05)。

结论

GERD和OSAHS的发病率和严重程度相互关联。反流事件可能加重OSAHS。这两种疾病在食管功能方面可能存在某种关系,尤其是在LES压力调节方面。

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