鼻阻塞与多导睡眠监测的相关性分析

Relationship between the nasal obstruction and polysomnography

目的 探讨合并慢性鼻塞的阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者鼻阻塞与多导睡眠监测（PSG）的相关性。方法 纳入经PSG诊断为OSAHS且合并慢性鼻塞的患者60例,对患者进行鼻阻力（RM）计和鼻声反射（AR）仪检查,获得150pa双侧鼻腔吸气总阻力（ITR）、双侧鼻腔呼气总阻力（ETR）、0~5cm鼻腔容积（NCV）、鼻腔最小横截面积（NMCA）参数数据,用Spearman法分析RM、AR各参数与PSG参数之间的相关性。结果 ETR与觉醒总次数（rs=0.353,P=0.006）、觉醒指数（AI）（rs=0.374,P=0.003）呈正相关性,与非动眼睡眠Ⅲ期和Ⅳ期时间百分比（N3＋N4,%）（rs=-0.316,P=0.014）呈负相关性。ETR值越大,觉醒总次数越多,AI值越高,N3＋N4（%）值越低。纳入的RM、AR各参数与呼吸暂停低通气指数（AHI）、最低血氧饱和度（LSaO2）、平均血氧饱和度（ASaO2）均未见明显相关性。结论 在合并慢性鼻塞的OSAHS患者中,呼气鼻阻力增加可能是睡眠觉醒增加和睡眠结构紊乱的危险因素,鼻阻塞对呼吸暂停指数无明显影响作用。

Objective To analyze the correlation between nasal obstruction and polysomnography （PSG） in patients with obstructive sleep apnea hyponea syndrome（OSAHS） complicating chronic nasal obstruction. Methods 60 patients （males） diagnosed with OSAHS by PSG complicating chronic nasal obstruction were included. Acoustic rhinometry and rhinomanometry was applied for all patients to obtain the data of nasal inspiratory total resistance （ ITR）, nasal expiratory total resistance （ETR）, 0 -5 cm nasal cavity volume （NCV）, nasal minimal cross sectional area （NMCA）. The Spearman correlation was analyzed between the indices of PSG and parameters of AR and RM. Results There was a significant relationship between ETR and total arousal, arousal index （ AI）, percentages of stage 3 - 4 non-REM sleep （ N3 ＋ N4, % ） （P 〈 0.05 ）. The ETR values increased, as the total arousal values and AI values increased, while N3 ＋ N4 （ % ） values decreased. The parameters of AR and RM was not significantly correlated with apnea hypopnea index （AHI）, lowest oxygen saturation （LSaO2 ）, and average oxygen saturation （ASaO2）. Conclusion In patients with OSAHS complicating chronic nasal obstruction, increased expiratory nasal resistance may be a risk factor for increased sleep arousal and disordered sleep architecture. Nasal obstruction has no significant effect on AHI.