变应性鼻炎对成人阻塞性睡眠呼吸暂停低通气综合征的影响

Effect of allergic rhinitis on adult obstructive sleep apnea hypopnea syndrome

目的探讨变应性鼻炎(allergic rhinitis,AR)对成人阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)的影响。方法筛选同时患有持续性AR及OSAHS(除外中枢性OSAHS)成人(年龄>18岁)共120例,进行血清Ig E、变应原检测,鼻内镜、多导睡眠监测(polysomnography,PSG)检查,比较患者系统抗过敏治疗前后鼻部症状评分、呼吸暂停低通气指数(apnea hypopnea index,AHI)、最低血氧饱和度(lowest oxygen saturation,LSa O2)、鼾声指数和嗜睡程度(epworth sleepiness scale,ESS)。结果持续性AR伴有轻度OSAHS患者经正规抗过敏治后AHI、LSa O2、ESS评分及鼾声指数分别为(7.74±0.62)次/h、(89.00±0.71)%、6.80±0.59、97.47±13.64,与治疗前(10.68±0.94)次/h、(81.10±0.46)%,8.82±0.66、131.48±19.23相比有显著改善(P<0.05)。持续性AR伴有中度OSAHS患者经正规抗过敏治疗后AHI、LSa O2、、ESS评分及鼾声指数分别为(15.53±1.83)次/h、(79.00±1.65)%、9.26±0.39、187.42±28.26,与治疗前(21.73±2.78)次/h、(70.60±1.77)%,13.53±1.78、234.39±33.79相比有显著改善(P<0.05)。持续性AR伴有重度OSAHS患者经抗过敏治疗后ESS评分由20.29±1.57降至14.47±1.04(P=0.037);鼾声指数由治疗前367.96±47.25降至252.54±36.47(P=0.029)。结论持续性AR伴OSAHS患者经过系统抗过敏治疗后鼻部症状明显改善;AR可加重OSAHS低通气及呼吸暂停次数,影响患者血氧饱和度,加重其白天嗜睡症状。

Objective To investigate the effects of allergic rhinitis（AR） on obstructive sleeP〈0apnea hypopnea syndrome（OSAHS） in adult. Methods One hundred and twenty adult patients（18 years） with allergic rhinitis and OSAHS were selected. Serum Ig E, allergen detection, nasal endoscope, and multi-guided sleeP〈0monitoring（PSG） were performed. The anti-allergy treatment of all patients, sleeping parameters including apnea hypopnea index（AHI）, snoring index, lowest oxygen saturation（LSa O2） and epworth sleepiness scale（ESS） were compared. Results Compared with pre-treatment, the AHI, LSa O2, ESS and snore index of patients with persistent AR and mild OSAHS after treatment improved significantly [（7.74±0.62）/h vs（10.68±0.94）/h,（89.00 ±0.71）% vs（81.10±0.46）%,（6.80±0.59） vs（8.82±0.66）,（97.47±13.64） vs（131.48±19.23）, P〈0.05]. Compared with pre-treatment, the AHI, LSa O2, ESS and snore index of patients with persistent AR and moderate OSAHS after treatment improved significantly [（15.53±1.83）/h vs（21.73±2.78）/h,（79.00±1.65）% vs（70.60±1.77）%,（9.26±0.39） vs（13.53±1.78）,（187.42±28.26） vs（234.39±33.79）, P〈0.05]. After treatment, ESS and snoring index of patients with persistent AR and severe OSAHS decreased significantly [（20.29±1.57） vs（14.47±1.04）, P=0.037;（367.96±47.25） vs（252.54±36.47）, P=0.029]. Conclusion The nasal symptoms improve significantly after regular anti allergy treatment. AR can increase AHI and affect Sa O2 which will cause daytime sleepiness in patients with OSAHS.