OSAHS患者肺順應(yīng)性與胃食管反流病相關(guān)性的研究
發(fā)布時間：2018-11-16 11:58
【摘要】：目的:評價OSAHS患者肺順應(yīng)性與胃食管反流程度之間的相關(guān)性,旨在探討OSAHS患者發(fā)生胃食管反流的可能機制。方法:選取2014年2月至2016年2月期間在新疆維吾爾自治區(qū)人民醫(yī)院耳鼻喉科疑似OSAHS首次入院患者,分別行常規(guī)肺功能檢查、多導睡眠監(jiān)測(PSG)、脈沖振蕩系統(tǒng)(IOS)、24h多通道阻抗-PH監(jiān)測系統(tǒng),制定納入排除標準,212例疑似患者中,確診為OSAHS患者117例,非OSAHS患者95例;其中62例OSAHS患者伴有病理性胃食管反流(A組);55例OSAHS患者不伴有病理性胃食管反流(B組);41例非OSAHS患者伴有病理性胃食管反流(C組);54例非OSAHS患者不伴有病理性胃食管反流(D組)。比較組間多導睡眠監(jiān)測參數(shù)、常規(guī)肺功能參數(shù)、脈沖振蕩測定指標、24h多通道阻抗-PH監(jiān)測參數(shù),并對其做相關(guān)分析。結(jié)果:A組(OSAHS伴GER)、B組(OSAHS不伴GER)、C組(非OSAHS伴GER)、D組(非OSAHS不伴GER)四組間AHI、LSa02差異有統(tǒng)計學意義(P0.05),而年齡和BMI差異無統(tǒng)計學意義(P0.05);四組間FRC和ERV差異有統(tǒng)計學意義(P0.05),而FVC、FEV1、FEV1/FVC、VC、TLC無顯著性差異(P0.05),A組的FRC和ERV低于B、C、D組,差異有統(tǒng)計學意義(P0.05);四組間Zrs5和R5、R10、R15和X5、X10、X15和Fres有差異且有統(tǒng)計學意義(P0.05),而A組與B組間Zrs5和R5、R10、R15和X5和Fres有差異且有統(tǒng)計學意義(P0.05);四組間UES的平均靜息壓力及殘余壓力、LES的平均靜息壓力及殘余壓力、弱酸反流次數(shù)差異均無統(tǒng)計學意義(P0.05);而反流總次數(shù)、酸反流次數(shù)、De Meester評分差異有統(tǒng)計學意義(P0.05),A組與B組、C組、D組相比,反流總次數(shù)、酸反流次數(shù)、De Meester評分組間差異均有統(tǒng)計學意義(P0.05)。相關(guān)分析顯示:OSAHS患者的AHI與R5和R20呈正相關(guān)(P0.05);LSa02與R5和R20呈負相關(guān)(P0.05);OSAHS患者的Zrs5和R5、R10、R15與反流總次數(shù)、De Meester評分呈正相關(guān)(P0.05);X5與反流總次數(shù)、De Meester評分呈負相關(guān)(P0.05)。結(jié)論:OSAHS患者呼吸系統(tǒng)力學特征發(fā)生改變,呼吸阻力增加和呼吸系統(tǒng)彈性增加,尤其是肺的順應(yīng)性下降可能與胃食管反流相關(guān)。
[Abstract]:Objective: to evaluate the relationship between gastroesophageal reflux (GER) and lung compliance in patients with OSAHS, and to explore the possible mechanism of gastroesophageal reflux (GER) in OSAHS patients. Methods: from February 2014 to February 2016, suspected OSAHS patients were admitted to the Department of Otorhinolaryngology, Xinjiang Uygur Autonomous region people's Hospital for the first time. Routine pulmonary function tests and polysomnography (PSG), pulse oscillation system (IOS),) were performed respectively. 24 h multi-channel impedance PH monitoring system was established and excluded. 117 cases were diagnosed as OSAHS patients and 95 cases as non-OSAHS patients out of 212 suspected patients. There were 62 cases of OSAHS with pathological gastroesophageal reflux (group A), 55 cases of OSAHS with no pathological gastroesophageal reflux (group B), 41 cases of non-OSAHS patients with pathological gastroesophageal reflux (group C). No pathological gastroesophageal reflux was found in 54 non-OSAHS patients (group D). The parameters of polysomnography, routine pulmonary function, pulse oscillation and 24 hours multichannel impedance-PH monitoring were compared, and the correlation analysis was made. Results: there were significant differences in AHI,LSa02 among four groups in group A (OSAHS with GER), B (OSAHS without GER), C) (non-OSAHS with GER), D) (non-OSAHS without GER) (P0.05), but there was no significant difference in age and BMI (P0.05). There was significant difference in FRC and ERV among the four groups (P0.05), but no significant difference in FVC,FEV1,FEV1/FVC,VC,TLC (P0.05). (P0.05) FRC and ERV in), A group were lower than those in), A group (P0.05). There was significant difference between Zrs5 and R5, R10, R15, X5, X10, X15 and Fres (P0.05), but there was significant difference between group A and group B in Zrs5, R5, R10, R15, X5 and Fres (P0.05). The average rest pressure and residual pressure of UES, the average rest pressure and residual pressure of LES, the times of weak acid reflux were not significantly different among the four groups (P0.05). However, the total number of reflux and the number of acid reflux in, De Meester score were significantly different between), A group and B group, C group and D group (P0.05), the total number of reflux and the number of acid reflux in group D were significantly higher than those in group B, group C and group D, respectively. There were significant differences in De Meester score between groups (P0.05). Correlation analysis showed that AHI was positively correlated with R5 and R20 in OSAHS patients (P0.05), LSa02 was negatively correlated with R5 and R20 (P0.05), Zrs5 and R5R10R15 in); OSAHS patients were positively correlated with, De Meester score of total reflux number (P0.05). X _ 5 was negatively correlated with the total number of reflux, De Meester scores (P 0.05). Conclusion: the mechanical characteristics of respiratory system, respiratory resistance and respiratory elasticity, especially the decrease of lung compliance, may be related to gastroesophageal reflux in patients with OSAHS.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R766
[Abstract]:Objective: to evaluate the relationship between gastroesophageal reflux (GER) and lung compliance in patients with OSAHS, and to explore the possible mechanism of gastroesophageal reflux (GER) in OSAHS patients. Methods: from February 2014 to February 2016, suspected OSAHS patients were admitted to the Department of Otorhinolaryngology, Xinjiang Uygur Autonomous region people's Hospital for the first time. Routine pulmonary function tests and polysomnography (PSG), pulse oscillation system (IOS),) were performed respectively. 24 h multi-channel impedance PH monitoring system was established and excluded. 117 cases were diagnosed as OSAHS patients and 95 cases as non-OSAHS patients out of 212 suspected patients. There were 62 cases of OSAHS with pathological gastroesophageal reflux (group A), 55 cases of OSAHS with no pathological gastroesophageal reflux (group B), 41 cases of non-OSAHS patients with pathological gastroesophageal reflux (group C). No pathological gastroesophageal reflux was found in 54 non-OSAHS patients (group D). The parameters of polysomnography, routine pulmonary function, pulse oscillation and 24 hours multichannel impedance-PH monitoring were compared, and the correlation analysis was made. Results: there were significant differences in AHI,LSa02 among four groups in group A (OSAHS with GER), B (OSAHS without GER), C) (non-OSAHS with GER), D) (non-OSAHS without GER) (P0.05), but there was no significant difference in age and BMI (P0.05). There was significant difference in FRC and ERV among the four groups (P0.05), but no significant difference in FVC,FEV1,FEV1/FVC,VC,TLC (P0.05). (P0.05) FRC and ERV in), A group were lower than those in), A group (P0.05). There was significant difference between Zrs5 and R5, R10, R15, X5, X10, X15 and Fres (P0.05), but there was significant difference between group A and group B in Zrs5, R5, R10, R15, X5 and Fres (P0.05). The average rest pressure and residual pressure of UES, the average rest pressure and residual pressure of LES, the times of weak acid reflux were not significantly different among the four groups (P0.05). However, the total number of reflux and the number of acid reflux in, De Meester score were significantly different between), A group and B group, C group and D group (P0.05), the total number of reflux and the number of acid reflux in group D were significantly higher than those in group B, group C and group D, respectively. There were significant differences in De Meester score between groups (P0.05). Correlation analysis showed that AHI was positively correlated with R5 and R20 in OSAHS patients (P0.05), LSa02 was negatively correlated with R5 and R20 (P0.05), Zrs5 and R5R10R15 in); OSAHS patients were positively correlated with, De Meester score of total reflux number (P0.05). X _ 5 was negatively correlated with the total number of reflux, De Meester scores (P 0.05). Conclusion: the mechanical characteristics of respiratory system, respiratory resistance and respiratory elasticity, especially the decrease of lung compliance, may be related to gastroesophageal reflux in patients with OSAHS.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R766
【參考文獻】
相關(guān)期刊論文 前10條
1 張賽;尤樂都斯;;食管動力和反流事件在OSAHS發(fā)病機制中意義[J];中華胃食管反流病電子雜志;2014年01期
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