阻塞性睡眠呼吸暂停综合征并胃食管反流病的影响因素研究

摘要

目的 分析阻塞性睡眠呼吸暂停综合征(OSAS)并胃食管反流病(GERD)的影响因素.方法 选取2011年3月—2017年6月在新疆维吾尔自治区人民医院呼吸科就诊的OSAS并GERD患者98例作为观察组,另按照体质指数(BMI)(BMI±1.5 kg/m2)1:2比例匹配单纯OSAS患者196例作为对照组.比较两组患者临床资料及睡眠呼吸监测结果,OSAS并GERD的影响因素分析采用多因素Logistic回归分析.结果 两组患者年龄、性别、BMI、颈围、打鼾时间、打鼾家族史、冠心病病史、糖尿病病史、高血压病史、咽腔狭窄者所占比例、扁桃体肿大者所占比例比较,差异无统计学意义(P>0.05);观察组患者睡眠呼吸紊乱指数(AHI)、呼吸暂停指数(AI)及血氧饱和度<90％时间占监测总时间的百分比(TS90％)高于对照组,最长呼吸暂停时间(LAT)、平均呼吸暂停时间(MAT)长于对照组,夜间最低血氧饱和度(LSaO2)、夜间平均血氧饱和度(MSaO2)低于对照组(P<0.05).多因素Logistic回归分析结果显示,AHI〔OR=2.743,95％CI(1.587,4.739)〕、AI〔OR=2.090,95％CI(1.865,2.341)〕、LAT〔OR=2.428,95％CI(1.817,3.245)〕、LSaO2〔OR=0.646,95％CI(0.480,0.870)〕、MSaO2〔OR=0.592,95％CI(0.470,0.744)〕是OSAS并GERD的独立影响因素(P<0.05).结论 AHI、AI、LAT、LSaO2、MSaO2是OSAS并GERD的独立影响因素,应引起临床重视.%Objective To analyze the influencing factors of gastroesophageal reflux disease(GERD)in patients with obstructive sleep apnea syndrome(OSAS).Methods From March 2011 to June 2017,a total of 98 OSAS patients merged with GERD were selected as observation group in the Department of Respiratory Medicine,the People's Hospital of Xinjiang Uygur Autonomous Region,meanwhile a total of 196 patients with OSAS only were selected as control group according to(BMI±1.5 kg/m2)matching principle and 1:2 ratio. Clinical data and sleep respiratory monitoring results were compared between the two groups,and multivariate Logistic regression analysis was used to analyze the influencing factors of GERD in patients with OSAS.Results No statistically significant differences of age,gender,BMI,neck circumference,snoring time,family history of snoring,history of coronary heart disease,diabetes mellitus or hypertension,proportion of patients with pharyngeal cavity stenosis or antiadoncus was found between the two groups(P>0.05);AHI,AI and percentage of oxyhemoglobin saturation less than 90％ during monitoring(TS90％)in observation group were statistically significantly higher than those in control group,LAT and MAT in observation group were statistically significantly longer than those in control group,while nighttime LSaO2 and nighttime MSaO2 in observation group were statistically significantly lower than those in control group(P<0.05). Multivariate Logistic regression analysis results showed that,AHI〔OR=2.743,95％CI(1.587,4.739)〕, AI〔OR=2.090,95％CI(1.865,2.341)〕,LAT〔OR=2.428,95％CI(1.817,3.245)〕,nighttime LSaO2〔OR=0.646,95％CI(0.480,0.870)〕and nighttime MSaO2〔OR=0.592,95％CI(0.470,0.744)〕were independent influencing factors of GERD in patients with OSAS(P<0.05).Conclusion AHI,AI,LAT,nighttime LSaO2 and nighttime MSaO2 are independent influencing factors of GERD in patients with OSAS,which should pay more attentions to.