Riha Renata L, Kotoulas Serafeim-Chrysovalantis, Pataka Athanasia, Kvamme John Arthur, Joppa Pavol, Hedner Jan
Sleep Research Unit, The University of Edinburgh, Department of Sleep Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, EH16 4SA, Edinburgh, Scotland, UK.
Sleep Research Unit, The University of Edinburgh, Department of Sleep Medicine, Royal Infirmary of Edinburgh, 51 Little France Crescent, EH16 4SA, Edinburgh, Scotland, UK.
Sleep Med. 2021 Feb;78:189-192. doi: 10.1016/j.sleep.2020.11.024. Epub 2020 Nov 24.
The impact of removing the upper airway lymphoid tissue and in particular, tonsillectomy, in adults with OSA has not been demonstrated in large populations.
To compare the severity of OSA and the prevalence of cardiovascular, metabolic and respiratory co-morbidities between patients with OSA who had undergone previous tonsillectomy and those who had not.
The 19,711 participants in this study came from the European sleep apnea database (ESADA) which comprises data from unselected adult patients aged 18-80 years with a history of symptoms suggestive of OSA referred to sleep centers throughout Europe.
There were no differences between the two groups in terms of sex ratio and age (146 patients with previous tonsillectomy vs. 19565 patients without). Patients who had undergone tonsillectomy had a lower body mass index (29.3 ± 5.2 kg/m vs 32.2 ± 6.6 kg/m, p < 0.001), lower subjective sleep latency (17.1 ± 17.8 min vs 25.5 ± 30.4 min, p = 0.001), lower ODI (15.7 ± 18.3 events/hour vs 30.7 ± 26.1 events/hour, p < 0.001), and SpO<90% time during sleep (21.8 ± 47.5 min vs 52.6 ± 80.8 min, p < 0.001). OSA patients with tonsillectomy had a lower prevalence of Type II diabetes mellitus (p = 0.001), hypertension (p < 0.001) and a higher prevalence of hyperlipidemia (p < 0.001) and were less likely to be commenced on CPAP (p < 0.001).
In a large population of almost 20,000 OSA patients from across Europe, patients who had undergone tonsillectomy presented with less severe OSA at time of diagnosis, and had a lower prevalence of Type II diabetes mellitus and cardiovascular co-morbidities.
在上气道淋巴组织切除尤其是扁桃体切除对成年阻塞性睡眠呼吸暂停（OSA）患者的影响方面，尚未在大量人群中得到证实。
比较既往接受过扁桃体切除的OSA患者与未接受过扁桃体切除的患者之间OSA的严重程度以及心血管、代谢和呼吸合并症的患病率。
本研究中的19711名参与者来自欧洲睡眠呼吸暂停数据库（ESADA），该数据库包含来自欧洲各地睡眠中心的18 - 80岁未经过筛选的有OSA症状史成年患者的数据。
两组在性别比例和年龄方面无差异（146例既往有扁桃体切除史的患者与19565例无扁桃体切除史的患者）。接受过扁桃体切除的患者体重指数较低（29.3±5.2kg/m² 对32.2±6.6kg/m²，p<0.001），主观睡眠潜伏期较短（17.1±17.8分钟对25.5±30.4分钟，p = 0.001），氧减指数（ODI）较低（15.7±18.3次/小时对30.7±26.1次/小时，p<0.001），睡眠期间SpO₂<90%的时间较短（21.8±47.5分钟对52.6±80.8分钟，p<0.001）。有扁桃体切除史的OSA患者II型糖尿病患病率较低（p = 0.001），高血压患病率较低（p<0.001），高脂血症患病率较高（p<0.001），且开始使用持续气道正压通气（CPAP）的可能性较小（p<0.001）。
在来自欧洲的近20000名OSA患者的大量人群中，接受过扁桃体切除的患者在诊断时OSA症状较轻，且II型糖尿病和心血管合并症的患病率较低。
