奥美拉唑联合多潘立酮治疗阻塞性睡眠呼吸暂停低通气综合征伴咽喉反流性疾病的临床效果

Clinical effect of omeprazole combined with domperidone in treating obstructive sleep apnea-hypopnea syndrome complicated with laryngopharyngeal reflux disease

目的 探讨奥美拉唑联合多潘立酮治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）伴咽喉反流性疾病（LPRD）的临床效果.方法 选择2013年5月至2015年5月就诊于首都医科大学附属北京安贞医院并确诊为OSAHS伴LPRD的患者51例,所有患者均给予奥美拉唑肠溶胶囊（20 mg,2次/d口服）和多潘立酮片（10 mg,3次/d口服）,治疗8周.治疗前和治疗第2、4、8周分别行反流症状指数评分（RSI）和反流体征评分（RFS）;治疗前、治疗后8周后行多导睡眠监测.结果 治疗2、4周后,RSI＞ 13分和RFS＞7分患者比例与治疗前相比,差异无统计学意义（P＞0.05）.治疗8周后,RSI＞ 13分和RFS＞7分患者比例均明显低于治疗前[9.8％ （5/51）比88.2％ （45/51）,9.8％ （5/51）比92.2％ （47/51）],差异均有统计学意义（均P ＜0.05）;治疗8周后,多导睡眠监测结果显示,患者睡眠结构明显改善,总睡眠时间中Ⅰ期睡眠占比低于治疗前[（12.2±2.2）％比（15.5±3.2）％]、Ⅲ期睡眠和快速眼动睡眠占比高于治疗前[（4.7±0.4）％比（2.5±0.3）％、（26.7±7.8）％比（23.8±8.7）％],呼吸暂停低通气指数、低通气指数、微觉醒次数明显低于治疗前[（38±10）次/h比（46±12）次/h、（9±4）次/h比（14±6）次/h、（22±9）次/h比（35±12）次/h],差异均有统计学意义（均P＜0.05）.结论 奥美拉唑联合多潘立酮能有效缓解OSAHS伴LPRD患者的症状和体征,提高患者睡眠质量.

Objective To explore the clinical effect of omeprazole combined with domperidone in treating obstructive sleep apnea-hypopnea syndrome （OSAHS） complicated with laryngopharyngeal reflux disease （LPRD）.Methods Totally 51 OSAHS patients complicated with LPRD from May 2013 to May 2015 were treated with omeprazole enteric capsules （20 mg,2 times/d） and domperidone （10 mg,3 times/d） for 8 weeks.The reflux symptom index score （RSI） and reflux finding score （RFS） were measured before,2,4 and 8 weeks after treatment;polysomnography was performed before and 8 weeks after treatment.Results After 2 and 4 weeks of treatment,the proportions of patients with RSI 〉 13 scores and RFS 〉 7 scores were not significantly changed compared with those before treatment （P 〉 0.05）;after 8 weeks of treatment,the proportions of patients with RSI 〉 13 scores and RFS 〉7 scores were significantly lower than those before treatment [9.8% （5/51） vs 88.2% （45/51）,9.8% （5/51） vs 92.2% （47/51）] （P 〈0.05）.Eight weeks after treatment,polysomnography monitoring showed that the sleep structure was significantly improved,showing as followed：the proportion of Ⅰ period sleep was significantly lower,the proportions of Ⅲ period sleep and rapid eye movement sleep were significantly higher than those before treatment [（12.2 ± 2.2） % vs （15.5 ± 3.2） %,（4.7 ± 0.4） % vs （2.5 ± 0.3） %,（26.7 ± 7.8） % vs （23.8 ± 8.7） %],in addition,the apnea hypopnea index,hypopnea index,micro arousals were significantly lower than those before treatment [（38 ± 10） times/h vs （46 ± 12） times/h,（9 ±4） times/h vs （14 ±6） times/h,（22 ±9） times/h vs （35 ± 12） times/h] （P 〈0.05）.Conclusion Omeprazole combined with domperidone can effectively relieve symptoms and signs in OSAHS patients complicated with LPRD and improve the quality of sleep.