CAJ | 학술논문

目的：探讨变应性鼻炎(allergic rhinitis，AR)对成人阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome，OSAHS)的影响。方法筛选同时患有持续性AR及OSAHS(除外中枢性OSAHS)成人(年龄>18岁)共120例，进行血清IgE、变应原检测，鼻内镜、多导睡眠监测(polysomnography，PSG)检查，比较患者系统抗过敏治疗前后鼻部症状评分、呼吸暂停低通气指数(apnea hypopnea index，AHI)、最低血氧饱和度(lowest oxygen saturation，LSaO2)、鼾声指数和嗜睡程度(epworth sleepiness scale，ESS)。结果持续性AR伴有轻度OSAHS患者经正规抗过敏治后AHI、LSaO2、ESS评分及鼾声指数分别为(7.74±0.62)次/h、(89.00±0.71)%、6.80±0.59、97.47±13.64，与治疗前(10.68±0.94)次/h、(81.10±0.46)%，8.82±0.66、131.48±19.23相比有显著改善(P＜0.05)。持续性AR伴有中度OSAHS患者经正规抗过敏治疗后AHI、LSaO2、、ESS评分及鼾声指数分别为(15.53±1.83)次/h、(79.00±1.65)%、9.26±0.39、187.42±28.26，与治疗前(21.73±2.78)次/h、(70.60±1.77)%，13.53±1.78、234.39±33.79相比有显著改善(P＜0.05)。持续性AR伴有重度OSAHS患者经抗过敏治疗后ESS评分由20.29±1.57降至14.47±1.04(P=0.037)；鼾声指数由治疗前367.96±47.25降至252.54±36.47(P=0.029)。结论持续性AR伴OSAHS患者经过系统抗过敏治疗后鼻部症状明显改善；AR可加重OSAHS低通气及呼吸暂停次数，影响患者血氧饱和度，加重其白天嗜睡症状。
목적：탐토변응성비염(allergic rhinitis，AR)대성인조새성수면호흡잠정저통기종합정(obstructive sleep apnea hypopnea syndrome，OSAHS)적영향。방법사선동시환유지속성AR급OSAHS(제외중추성OSAHS)성인(년령>18세)공120례，진행혈청IgE、변응원검측，비내경、다도수면감측(polysomnography，PSG)검사，비교환자계통항과민치료전후비부증상평분、호흡잠정저통기지수(apnea hypopnea index，AHI)、최저혈양포화도(lowest oxygen saturation，LSaO2)、한성지수화기수정도(epworth sleepiness scale，ESS)。결과지속성AR반유경도OSAHS환자경정규항과민치후AHI、LSaO2、ESS평분급한성지수분별위(7.74±0.62)차/h、(89.00±0.71)%、6.80±0.59、97.47±13.64，여치료전(10.68±0.94)차/h、(81.10±0.46)%，8.82±0.66、131.48±19.23상비유현저개선(P＜0.05)。지속성AR반유중도OSAHS환자경정규항과민치료후AHI、LSaO2、、ESS평분급한성지수분별위(15.53±1.83)차/h、(79.00±1.65)%、9.26±0.39、187.42±28.26，여치료전(21.73±2.78)차/h、(70.60±1.77)%，13.53±1.78、234.39±33.79상비유현저개선(P＜0.05)。지속성AR반유중도OSAHS환자경항과민치료후ESS평분유20.29±1.57강지14.47±1.04(P=0.037)；한성지수유치료전367.96±47.25강지252.54±36.47(P=0.029)。결론지속성AR반OSAHS환자경과계통항과민치료후비부증상명현개선；AR가가중OSAHS저통기급호흡잠정차수，영향환자혈양포화도，가중기백천기수증상。
Objective To investigate the effects of allergic rhinitis (AR) on obstructive sleep apnea hypopnea syndrome (OSAHS) in adult. Methods One hundred and twenty adult patients (>18 years) with allergic rhinitis and OSAHS were selected. Serum IgE, allergen detection, nasal endoscope, and multi-guided sleep monitoring (PSG) were performed. The anti-allergy treatment of all patients, sleeping parameters including apnea hypopnea index (AHI), snoring index, lowest oxygen saturation (LSaO2) and epworth sleepiness scale (ESS) were compared.Results Compared with pre-treatment, the AHI, LSaO2, ESS and snore index of patients with persistent AR and mild OSAHS after treatment improved significantly [(7.74±0.62)/hvs(10.68±0.94)/h, (89.00±0.71)%vs (81.10±0.46)%, (6.80±0.59)vs (8.82±0.66), (97.47±13.64)vs(131.48±19.23),P<0.05]. Compared with pre-treatment, the AHI, LSaO2, ESS and snore index of patients with persistent AR and moderate OSAHS after treatment improved significantly [(15.53±1.83)/h vs(21.73±2.78)/h, (79.00±1.65)%vs (70.60±1.77)%, (9.26±0.39)vs (13.53±1.78), (187.42±28.26)vs (234.39±33.79),P<0.05]. After treatment, ESS and snoring index of patients with persistent AR and severe OSAHS decreased significantly [(20.29±1.57)vs (14.47±1.04),P=0.037; (367.96±47.25)vs (252.54±36.47),P=0.029].ConclusionThe nasal symptoms improve significantly after regular anti allergy treatment. AR can increase AHI and affect SaO2 which will cause daytime sleepiness in patients with OSAHS.