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[与白天鼻腔呼吸正常的阻塞性睡眠呼吸暂停患者相比,白天鼻腔呼吸减弱的阻塞性睡眠呼吸暂停综合征患者的既往史和多导睡眠图参数]

[Anamnestic and polygraphic parameters in obstructive sleep apnea syndrome patients with reduced nasal respiration during the day in comparison with obstructive sleep apnea patients with normal nasal respiration].

作者信息

Duchna H W, Rasche K, Orth M, Bauer T T, Schultze-Werninghaus G

机构信息

Berufsgenossenschaftlichen Kliniken Bergmannshell, Universitätsklinik/Ruhr-Universität Bochum, Deutshland.

出版信息

Wien Med Wochenschr. 1996;146(13-14):348-9.

PMID:9012179
Abstract

Nasal obstruction is a predictive factor for snoring and may contribute to the development of an obstructive sleep apnea syndrome (OSAS). The aim of this study was to further evaluate the impact of nasal obstruction in OSAS. Therefore, we investigated 2 groups of OSAS-patients, matched pairs concerning gender, age, and BMI: OSAS-patients with nasal obstruction (N, n = 28), total nasal airflow < 500 ccm/s (referred to 150 pa pressure of difference or unilateral nasal resistance > 1 pa/ccm/s), and 28 OSAS-patients without nasal obstruction (control-group K, total nasal airflow > 700 ccm/s [referred to 150 pa pressure of difference or unilateral nasal resistance > 1 pa/ccm/s]). We performed anterior rhinomanometry, lung-function testing, cardio-respiratory polygraphy, and patients answered a standardized questionnaire. We found the following significant differences: 1) N complained more often (n = 17) about dyspnea at night than K (n = 7, p < 0.05, Chi2-test). 2) N had a higher apnea index (20.4 +/- 19.0/h) than K (9.6 +/- 10.0/h, p < 0.05, Student's t-test). There were, however, no significant differences concerning lung function, number of nocturnal hypopneas, nocturnal SaO2 and heart rate. Our results underline the importance of nasal ventilation in the pathogenesis of OSAS. At least in moderate cases of OSAS a therapy of nasal obstruction might be of success in order to abolish nCPAP-therapy or might reduce nasal problems during nCPAP-therapy and thus ameliorate patient's therapy compliance.

摘要

鼻阻塞是打鼾的一个预测因素,可能会促使阻塞性睡眠呼吸暂停综合征(OSAS)的发生。本研究的目的是进一步评估鼻阻塞在OSAS中的影响。因此,我们调查了两组OSAS患者,这两组在性别、年龄和体重指数方面相互匹配:有鼻阻塞的OSAS患者(N组,n = 28),总鼻气流< 500 ccm/s(相当于压差150 pa或单侧鼻阻力> 1 pa/ccm/s),以及28例无鼻阻塞的OSAS患者(对照组K,总鼻气流> 700 ccm/s [相当于压差150 pa或单侧鼻阻力> 1 pa/ccm/s])。我们进行了前鼻测压、肺功能测试、心肺多导睡眠监测,并且患者回答了一份标准化问卷。我们发现了以下显著差异:1)N组(n = 17)比K组(n = 7,p < 0.05,卡方检验)更常抱怨夜间呼吸困难。2)N组的呼吸暂停指数(20.4 +/- 19.0/小时)高于K组(9.6 +/- 10.0/小时,p < 0.05,学生t检验)。然而,在肺功能、夜间呼吸暂停低通气次数、夜间血氧饱和度和心率方面没有显著差异。我们的结果强调了鼻通气在OSAS发病机制中的重要性。至少在中度OSAS病例中,治疗鼻阻塞可能会成功,从而避免使用持续气道正压通气(nCPAP)治疗,或者可能会减少nCPAP治疗期间的鼻部问题,进而改善患者的治疗依从性。

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