Division of ENT Diseases, Department of Clinical Sciences Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden.
Laryngoscope. 2021 Jan;131(1):E307-E313. doi: 10.1002/lary.28960. Epub 2020 Jul 24.
To investigate whether modified uvulopalatopharyngoplasty (UPPP) for treatment of obstructive sleep apnea (OSA) remained effective after 8 years.
Prospective intervention study. Sixty-five patients with OSA were offered re-evaluation with polysomnography and the Epworth Sleepiness Scale (ESS) 8 years after UPPP. Results were compared with baseline and with a previous 2-year follow-up. Baseline predictors were analyzed with regression analyses.
The dropout rate at the 8-year follow-up was 28%. The mean decrease in apnea-hypopnea index (AHI) between baseline and the 8-year follow-up was significant, 14.0 events/hour (from 52.9 to 38.9), 27% (P < .001). The mean increase in AHI between the 2-year and the 8-year follow-up was significant, 14.7 events/hour (from 24.2 to 38.9), 61% (P < .0001). Overweight at baseline predicted an AHI at the 8-year follow-up that was 22.9 events higher compared to patients with normal weight (P = .015). An increase in body mass index (BMI) of 1 kg/m between baseline and the 8-year follow-up predicted a mean AHI increase of 3.8 events/hour (P = .015). The median decrease in ESS between baseline and the 8-year follow-up was significant, 7 (from 13.0 to 6.0), 54% (P < .0001). The median increase in ESS between the 2-year and the 8-year follow-up was not significant, 1.0 (from 5.0 to 6.0), 20%.
Modified UPPP was effective as a long-term treatment for OSA in selected patients, although the effect on AHI decreased over time. Daytime sleepiness remained improved even in the long term. High BMI at baseline and an increase in BMI predicted a reduced long-term respiratory outcome.
3 Laryngoscope, 131:E307-E313, 2021.
研究改良悬雍垂腭咽成形术（UPPP）治疗阻塞性睡眠呼吸暂停（OSA）8 年后是否仍有效。
前瞻性干预研究。65 例 OSA 患者在 UPPP 后 8 年接受多导睡眠图和 Epworth 嗜睡量表（ESS）重新评估。结果与基线和 2 年随访进行比较。采用回归分析对基线预测因子进行分析。
8 年随访的失访率为 28%。与基线相比，8 年随访时呼吸暂停低通气指数（AHI）的平均下降具有显著统计学意义，14.0 次/小时（从 52.9 次/小时降至 38.9 次/小时），下降 27%（P<0.001）。与 2 年随访相比，8 年随访时 AHI 的平均增加具有显著统计学意义，14.7 次/小时（从 24.2 次/小时增至 38.9 次/小时），增加 61%（P<0.0001）。基线时超重预测 AHI 较体重正常患者高 22.9 次/小时（P=0.015）。基线与 8 年随访之间 BMI 增加 1kg/m2 预测 AHI 平均增加 3.8 次/小时（P=0.015）。与基线相比，8 年随访时 ESS 的中位数显著下降，7（从 13.0 分降至 6.0 分），下降 54%（P<0.0001）。与 2 年随访相比，8 年随访时 ESS 的中位数增加不显著，1.0（从 5.0 分增至 6.0 分），增加 20%。
在选择的患者中，改良 UPPP 是治疗 OSA 的有效长期方法，尽管随着时间的推移，对 AHI 的影响会降低。即使在长期随访中，日间嗜睡仍得到改善。基线时 BMI 较高和 BMI 增加预测长期呼吸结局降低。
3 Laryngoscope，131：E307-E313，2021。
