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睡眠呼吸紊乱对嗅觉功能的影响:通过呼吸暂停低通气指数进行分析。

The Effect of Sleep Disordered Breathing on Olfactory Functions: Analysis by Apnea-Hypopnea Index.

作者信息

Shin Dong-Hyuk, Ahn Sung Hwan, Yang Youngsoo, Choi Seongjun, Cho Jae Hoon, Hong Seok-Chan, Kim Jin Kook

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University College of Medicine, Seoul, Korea.

出版信息

Clin Exp Otorhinolaryngol. 2017 Mar;10(1):71-76. doi: 10.21053/ceo.2015.01438. Epub 2016 Jun 25.

Abstract

OBJECTIVES

One hypothesis of obstructive sleep apnea syndrome (OSAS) is that long-standing snoring vibrations and hypoxia of the nerves cause a local neuropathy in the upper airway during sleep. The aim of this study was to investigate olfactory function in subjects comprising snorers and untreated subjects with OSAS, and to correlate data with polysomnographic parameters.

METHODS

Sixty-nine patients were evaluated for snoring from January 2010 to December 2013. The mild group (apneahypopnea index [AHI]<15) consisted of 19 subjects, and the moderate-severe group (AHI≥15) consisted of 50 subjects. Exclusion criteria were conductive olfactory dysfunction, previous tonsil or soft palatal surgery, central sleep apnea, and medications that are known to affect peripheral nerves. Nocturnal polysomnography and olfactory function test such as Korean version of Sniffin's stick test I, II (KVSS I, II) were performed.

RESULTS

There was a significant difference in body mass index, average oxygen saturation (SaO2), lowest SaO2, average snoring duration, and KVSS I, II between the two groups. AHI was related to odor threshold score, and average SaO2 was related to odor discrimination score. But, odor identification score showed no relation with AHI and average SaO2 except for age. Average SaO2 and AHI were closely related to the function of smell.

CONCLUSION

Hypoxia and low nasal airflow caused by OSAS may have an effect on the olfactory function. On comparison between the two groups, patients with a high AHI, especially those with OSAS, had an olfactory dysfunction. Also, low average oxygen is the main risk factor in determining the olfactory function. In people with OSAS, the possibility of olfactory dysfunction should be considered and an olfactory function test should be performed.

摘要

目的

阻塞性睡眠呼吸暂停综合征(OSAS)的一种假说认为,长期的打鼾振动和神经缺氧会在睡眠期间导致上呼吸道局部神经病变。本研究的目的是调查打鼾者和未经治疗的OSAS患者的嗅觉功能,并将数据与多导睡眠图参数相关联。

方法

2010年1月至2013年12月对69例患者进行打鼾评估。轻度组(呼吸暂停低通气指数[AHI]<15)由19名受试者组成,中度 - 重度组(AHI≥15)由50名受试者组成。排除标准为传导性嗅觉功能障碍、既往扁桃体或软腭手术史、中枢性睡眠呼吸暂停以及已知会影响周围神经的药物。进行夜间多导睡眠图检查和嗅觉功能测试,如韩国版嗅觉棒测试I、II(KVSS I、II)。

结果

两组之间的体重指数、平均血氧饱和度(SaO2)、最低SaO2、平均打鼾持续时间以及KVSS I、II存在显著差异。AHI与气味阈值评分相关,平均SaO2与气味辨别评分相关。但是,除年龄外,气味识别评分与AHI和平均SaO2无关。平均SaO2和AHI与嗅觉功能密切相关。

结论

OSAS引起的缺氧和低鼻气流可能对嗅觉功能有影响。两组比较时,AHI高的患者,尤其是OSAS患者,存在嗅觉功能障碍。此外,低平均血氧是决定嗅觉功能的主要危险因素。对于OSAS患者,应考虑嗅觉功能障碍的可能性并进行嗅觉功能测试。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/55f6/5327596/6cd700340eb8/ceo-2015-01438f1.jpg

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