Liu Lianlian, Wang Xiaoyu, Zhang Jinhong, Liu Zhi, Zhang Chun, Pan Yufei, Li Jinrang
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China; Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China.
Department of Otolaryngology-Head and Neck Surgery, The Sixth Medical Center of PLA General Hospital, Beijing, China.
J Voice. 2023 Oct 12. doi: 10.1016/j.jvoice.2023.09.018.
To investigate the relationship between laryngopharyngeal reflux (LPR) and obstructive sleep apnea (OSA).
Patients diagnosed with OSA who were hospitalized in the Department of Otolaryngology-Head and Neck Surgery from November 2021 to April 2022 were selected, and male patients with non-OSA during the same period were selected as the control group. Patients who participated in the study completed the Reflux Symptom Index (RSI), the Reflux Finding Sign (RFS), and 24-hour multichannel intraluminal impedance-pH (MII-pH) monitoring. RSI, RFS, and outcomes of 24 hour-MII-pH monitoring were compared between the OSA group and the control group.
A total of 86 patients were enrolled, of whom 49 were OSA patients and 37 were non-OSA patients. The positive rate of LPR (97.96% vs 75.68%) and the median number of LPR episodes (9 vs 5) were significantly higher in OSA patients than in non-OSA patients (P < 0.01, P < 0.05, respectively). A logistic regression model including body mass index, alcohol consumption, and the presence of OSA showed that having OSA was a risk factor for the occurrence of LPR (P < 0.05, OR [odds ratio] = 9.995, 95% CI [confidence interval] 1.084-92.181). There were correlations between Apnea-Hypopnea Index and the number of non-acid LPR episodes and the number of alkaline LPR episodes (r = 0.243, P < 0.05, r = 0.274, P < 0.05, respectively).
Having OSA is a risk factor for LPR, and LPR episodes occur more frequently in patients with OSA compared to those without OSA. When OSA is comorbid with LPR, the occurrence of alkaline LPR, such as bile reflux, should be a concurrent concern.
探讨喉咽反流（LPR）与阻塞性睡眠呼吸暂停（OSA）之间的关系。
选取2021年11月至2022年4月在耳鼻咽喉头颈外科住院的确诊为OSA的患者，并选取同期非OSA的男性患者作为对照组。参与研究的患者完成反流症状指数（RSI）、反流发现体征（RFS）以及24小时多通道腔内阻抗-pH（MII-pH）监测。比较OSA组和对照组之间的RSI、RFS以及24小时MII-pH监测结果。
共纳入86例患者，其中49例为OSA患者，37例为非OSA患者。OSA患者的LPR阳性率（97.96% 对75.68%）和LPR发作中位数（9次对5次）显著高于非OSA患者（分别为P < 0.01，P < 0.05）。包含体重指数、饮酒情况和OSA情况的逻辑回归模型显示，患有OSA是发生LPR的危险因素（P < 0.05，比值比[OR] = 9.995，95%置信区间[CI] 1.084 - 92.181）。呼吸暂停低通气指数与非酸性LPR发作次数和碱性LPR发作次数之间存在相关性（分别为r = 0.243，P < 0.05，r = 0.274，P < 0.05）。
患有OSA是LPR的危险因素，与无OSA的患者相比，LPR发作在OSA患者中更频繁。当OSA与LPR合并存在时，应同时关注碱性LPR的发生，如胆汁反流。
