男性OSAHS患者鼻声反射参数与CPAP压力的相关分析

Correlation between acoustic rhinometry and continuous positive airway pressure therapy in male patients with obstructive sleep apnea-hyponea syndrome

目的:探讨男性阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者鼻声反射测量与持续正压通气(CPAP)治疗压力的相关性。方法:选择男性OSAHS患者108例(轻度9例,中度20例,重度79例),测量项目包括睡眠呼吸紊乱指数(AHI),鼻声反射测量应用减充血剂前后鼻腔容积(NV)、最小鼻腔横截面积(MCA),鼻气道总阻力(NR),CPAP治疗压力(PCPAP)和治疗后睡眠呼吸暂停低通气指数(AHICPAP),体重指数(BMI)。应用SPSS16.0软件包进行3组OS-AHS男性患者各数据间相关分析,3组患者间资料差异应用单因素方差分析,3组患者CPAP治疗前、后睡眠呼吸暂停低通气指数(AHI与AHICPAP)的差异应用t检验。结果:(1)男性轻度OSAHS患者,PCPAP与AHI、BMI、NR无相关性(P>0.05);PCPAP与应用减充血剂前、后鼻腔最小横截面积(B.MCA、C.MCA)、应用减充血剂后双侧鼻气道前2cm容积平均值(C.V0～2)有正相关性(P<0.05)。(2)男性中度OSAHS患者,PCPAP与AHI、BMI、NR、应用减充血剂前、后鼻声反射各测量值均无相关性(P>0.05)。(3)男性重度OSAHS患者,PCPAP与AHI、BMI,AHI与BMI有正相关性(P<0.01)。PCPAP与应用减充血剂前、后鼻声反射各测量值、NR均无相关性(P>0.05)。(4)3组患者应用减充血剂前后鼻声反射各测量值、NR、AHICPAP的差异无统计学意义(P>0.05);3组患者间的BMI的差异有统计学意义(P<0.05),PCPAP的差异有显著性(P<0.01);各类程度男性OSAHS患者,CPAP治疗前、后AHI的差异具有显著性(P<0.01)。结论:3组患者鼻气道因素无明显差别,但PCPAP有显著差异。对于男性轻度OSAHS患者,PCPAP主要受鼻因素影响。在男性中度、重度OSAHS患者中,鼻因素对PCPAP的影响较小。

PURPOSE：To explore the correlation between acoustic rhinometry and continuous positive airway pressure therapy in male patient with obstructive sleep apnea-hyponea syndrome（OSAHS）.METHODS：108 OSAHS male patients received and completed the polysomnogram（PSG）,AR,CPAP therapy.Their body mass index（BMI） was calculated.Data in each group was compared between pre-CPAP and post-CPAP values with t test and among the 3 groups with one-way ANOVA.And data in each group were analyzed for correlation.All the data were analysed by using SPSS16.0 software package.RESULTS：（1） In patients with mild OSAHS,the correlations between the pressure（PCPAP） of CPAP therapy and AHI,PCPAP and BMI,PCPAPand NR were not statistically significant（P0.05）.After application of ephedrine hydrochloride,the correlations between PCPAP and minimal cross-sectional area（MCA）（P0.01）,PCPAP and first 2 cm nasal volume（P0.05） were statistically significant.（2） In patients with moderate OSAHS,the correlations between PCPAP and AHI,PCPAP and BMI,PCPAP and NR,PCPAP and AR before or after application of ephedrine hydrochloride were not statistically significant（P0.05）.（3） In patients with severe OSAHS,the correlations between PCPAP and AHI,PCPAP and BMI,AHI and BMIwere statistically significant（P0.01）.The correlation between PCPAP and AR before or after application of ephedrine hydrochloride,PCPAP and NR were not statistically significant（P0.05）.（4） The differences of the three groups＇ measurements of AR were not statistically significant（P0.05）.The differences of the three groups＇ BMI（P0.05） and PCPAP（P0.01） were statistically significant.The difference between AHI before and after CPAP therapy was statistically significant（P0.01）.CONCLUSION：For patients with mild OSAHS,PCPAP may be more dependent on MCA and NV after application of ephedrine hydrochloride than AHI and BMI.But in patients with moderate or severe OSAHS,the nasal factors seem not to play a more important role.