鼻阻力指标检测在阻塞性睡眠呼吸暂停综合征患者中的应用价值

Application of nasal resistance index in patients with obstructive sleep apnea-hypopnea syndrome

目的探讨检测鼻阻力指标对阻塞性睡眠呼吸暂停综合征(OSAHS)患者的临床意义。方法选取20例OSAHS患者作为OSAHS组,20例鼾症患者为鼾症组,30例健康志愿者为对照组,均接受多导睡眠监测及CT扫描,探讨不同组受试者鼻阻力指标差异以及鼻阻力指标与鼻腔容积及鼻黏膜面积的相关性。结果 1 OSAHS组患者觉醒次数、鼾声指数、呼吸暂停低通气指数(AHI)及鼻阻力明显高于鼾症组及对照组,Sa O2最低值及鼻气流明显低于鼾症组及对照组,差异均有统计学意义(P<0.05);其中OSAHS组重度患者上述指标与中轻度患者比较差异有统计学意义(P<0.05);2对照组、鼾症组及OSAHS组在鼻腔黏膜面积、黏膜面积-容积比依次增大,鼻腔容积依次减小,差异有统计学意义(P<0.05);OSAHS鼻阻力与鼻腔黏膜面积呈正相关(r=0.672,P<0.05),与鼻腔面积呈负相关(r=-0.447,P<0.05)。结论鼻阻力指标可作为诊断OSAHS及衡量OSAHS病情严重程度的重要参考指标。

Objective To investigate the significance of nasal resistance index in patients with obstructive sleep apnea-hypopnea syndrome （OSAHS）. Methods Twenty patients with OSAHS were chosen as OSAHS group, 20 patients with snoring were selected as the snoring group, and 30 healthy volunteers were enrolled as the control group. All the participants underwent polysomnography examination and CT scan. The differences of nasal resistance index between the three groups were compared, and the correlations between the resistance index and nasal cavity volume, nasal mucosa area were analyzed. Results ①The awakenings, snoring index, apnea hypopnea index （AHI） and na-sal resistance of OSAHS group were significantly higher than those of the snoring group and control group. The mini-mum value of SaO2 and nasal airflow were significantly lower in OSAHS group than the snoring group and the control group （P〈0.05）. The above indexes had significant difference between severe and mild patients in OSAHS group （P〈0.05）.②The nasal mucosa area, the ratio of nasal mucosa area to nasal cavity volume increased successively in the control group, snoring group and OSAHS group, while the nasal cavity volume decreased successively, with statistical-ly significant difference （P〈0.05）. There were positive correlation between OSAHS nasal resistance and nasal mucosa area （r=0.672, P〈0.05）, and negative correlation between OSAHS nasal resistance and nasal area （r=-0.447, P〈0.05）. Conclusion Nasal resistance index can be used as important indicator for diagnosing OSAHS and evaluating the se-verity of OSAHS.