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中华胃食管反流病电子杂志 ›› 2016, Vol. 03 ›› Issue (02) : 66 -71. doi: 10.3877/cma.j.issn.1674-6899.2016.02.005

所属专题: 文献

论著

OSAHS患者呼吸系统力学特征与胃食管反流相关性的研究
张玉沛1, 张劲2,(), 艾力根·阿不都热依木2   
  1. 1. 852000 石河子,石河子大学医学院
    2. 830000 乌鲁木齐,新疆维吾尔自治区人民医院耳鼻喉诊疗中心
  • 收稿日期:2016-03-20 出版日期:2016-05-15
  • 通信作者: 张劲

Study on the correlation between mechanical characteristics of respiratory system and gastroesophageal reflux in patients with OSAHS

Yupei Zhang1, Jin Zhang2,(), Abdeyrim Arikin2   

  1. 1. Medical College of Shihezi University, Shihezi852000, China
    2. Department of ENT, People′s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 83000, China
  • Received:2016-03-20 Published:2016-05-15
  • Corresponding author: Jin Zhang
  • About author:
    Corresponding author: Zhang Jin, Email:
引用本文:

张玉沛, 张劲, 艾力根·阿不都热依木. OSAHS患者呼吸系统力学特征与胃食管反流相关性的研究[J/OL]. 中华胃食管反流病电子杂志, 2016, 03(02): 66-71.

Yupei Zhang, Jin Zhang, Abdeyrim Arikin. Study on the correlation between mechanical characteristics of respiratory system and gastroesophageal reflux in patients with OSAHS[J/OL]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2016, 03(02): 66-71.

目的

评价阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者呼吸系统力学特征及其胃食管反流程度之间的相关性,旨在探讨OSAHS患者发生胃食管反流的可能机制。

方法

选取2014年2月至2016年2月,在新疆维吾尔自治区人民医院耳鼻喉科疑似OSAHS首次入院患者,分别行常规肺功能检查、多导睡眠监测(PSG)、脉冲振荡系统(IOS)、24h多通道阻抗-pH监测系统,制定纳入排除标准,259例疑似患者中,确诊为OSAHS患者182例,非OSAHS患者77例;其中127例OSAHS患者伴有病理性胃食管反流(A组);55例OSAHS患者不伴有病理性胃食管反流(B组);23例非OSAHS患者伴有病理性胃食管反流(C组);54例非OSAHS患者不伴有病理性胃食管反流(D组)。比较组间各测量指标差异,并对其做相关分析。

结果

A、B、C、D组各组间BMI、AHI、LSaO2差异均有统计学差异(P<0.05);与B组、C组及D组相比A组的FRC和ERV显著下降,差异有统计学意义(P<0.05);其Zrs5和全部震荡频率的Rrs显著增高,而Xrs显著较低,差异均有统计学意义(P<0.05);食管反流总次数、食管近端酸反流指数和DeMeester评分A组显著高于B、C、D组(P<0.05);相关分析显示:OSAHS患者的Zrs5和5~15 Hz的Rrs与反流总次数、DeMeester评分呈正相关;OSAHS患者Xrs5的下降与反流总次数、DeMeester评分呈负相关。

结论

OSAHS患者呼吸系统力学特征发生改变,呼吸阻力增加和呼吸系统弹性特征,尤其是肺的顺应性下降与胃食管反流相关。

Objective

To explore the possible mechanism of gastroesophageal reflux in patients with obstructive sleep apnea hypopnea syndrome(OSAHS), this study evaluated the correlation between the mechanical characteristics of therespiratory system and the degree of gastroesophageal reflux in patients with OSAHS.

Methods

From February 2014 to February 2016, the suspected OSAHS patients admitted to hospital for the first timein People′s Hospital of Xinjiang Uygur Autonomous Region, were performed routine pulmonary function testand polysomnography(PSG), pulse oscillation system(IOS), 24h multi-channel impedance-pH monitoring system.The inclusion and exclusion criteriawereformulated.259 cases of suspected patients, 182 cases were diagnosed as OSAHS, and 77 cases were non-OSAHS patients; 127 cases of OSAHS patients with pathological gastroesophageal reflux(group A); 55 cases of OSAHS patients with abnormal gastroesophageal reflux(group B); 23 cases of non-OSAHS patients with pathological gastroesophageal reflux(group C); 54 cases of non-OSAHS patients without pathological gastroesophageal reflux(group D). The differences between the two groups were compared and analyzed.

Results

Group A, group B, group C and group D of BMI, AHI and LSaO2 had significant differences(P<0.05); Compared with group B, group C and group D, FRC and ERVof group A were significantly decreased, and had significant differences(P<0.05); the Zrs5 and all of the oscillation frequency of Rrswere significantly increased, and Xrswas significantly decreased.The differences were statistically significant(P<0.05); the total number of esophageal reflux, proximal esophageal acid reflux index and DeMeester score in group A was significantly higher than that of groupB, C and D(P<0.05); correlation analysis showed that OSAHS patients with Zrs5 and 5 to 15 Hz Rrs and the total number of reflux and DeMeester score were decreased in OSAHS Xrs5; the total number of reflux, DeMeester score was negatively correlated.

Conclusion

The mechanical characteristics of therespiratory system in OSAHS patients were changed, the respiratory resistance increased and the elastic characteristics of the respiratory system, especially the decrease in lung compliance was related to the gastroesophageal reflux.

表1 A、B、C、D组多导睡眠监测参数的比较(±s)
表2 A组、B组、C组、D组常规肺功能参数比较(±s)
表3 A组、B组、C组、D组呼吸系统力学特性测定及组间的比较(±s)
表4 A、B、C、D四组24 h多通道阻抗-pH监测参数及组间的比较(±s)
表5 OSAHS患者呼吸系统力学特征与胃食管反流的关系
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