上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (1): 60-.doi: 10.3969/j.issn.1674-8115.2011.01.014

• 论著（临床研究） • 上一篇    下一篇

胃食管反流病与阻塞性睡眠呼吸暂停综合征的关系

孙 璟1, 胡家安1, 徐志红1, 江石湖2   

  1. 上海交通大学 医学院附属瑞金医院 1.老年病科, 2.消化内科, 上海 200025
  • 出版日期:2011-01-28 发布日期:2011-02-01
  • 通讯作者: 胡家安, 电子信箱: jahu_rj@yahoo.com.cn。
  • 作者简介:孙 璟（1967—）, 男, 副主任医师, 硕士；电子信箱: shsunjing@yahoo.com。

Relationship between obstructive sleep apnea hypopnea syndrome and gastroesophageal reflux disease

SUN Jing1, HU Jia-an1, XU Zhi-hong1, JIANG Shi-hu2   

  1. 1.Department of Geriatrics, 2.Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2011-01-28 Published:2011-02-01

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摘要：

目的 探讨胃食管反流病（GERD）与阻塞性睡眠呼吸暂停低通气综合征（OSAHS）之间的关系。方法 收集100例OSAHA患者，所有患者完成反流性疾病诊断问卷（RDQ）调查，根据是否伴有GERD症状将患者分为伴有GERD组和无GERD组，比较两组患者的GERD症状积分、睡眠呼吸紊乱指数（AHI）及体质量指数（BMI）；根据OSAHS的病情程度将患者分为轻度组、中度组和重度组，比较三组患者的GERD症状积分、睡眠分期及动脉血氧饱和度（SaO2）情况。结果 OSAHS患者中GERD发生率为58%。伴有GERD患者的GERD症状积分、AHI和BMI均高于无GERD者,差异有统计学意义（P<0.05）。在所有OSAHS患者中，重度组OSAHS患者所占百分比明显高于轻度组和中度组，缺氧程度较轻度者重,差异也均有统计学意义（P<0.05或P<0.01），但三组间的GERD症状积分比较差异无统计学意义（P>0.05）。结论 OSAHS与GERD密切相关，对伴有病理性GERD的OSAHS患者，经鼻持续正压通气（nCPAP）联合抗反流药物治疗可能有良好的疗效。

关键词: 睡眠呼吸暂停, 胃食管反流病, 呼吸暂停低通气指数

Abstract:

Objective To investigate the relationship between gastroesophageal reflux disease (GERD) and obstructive sleep apnea hypopnea syndrome (OSAHS). Methods One hundred patients with OSAHA were selected, and all completed reflux disease questionnaires (RDQ). Patients were divided into GERD group and non-GERD group according to symptoms of GERD, and GERD symptom score, apnea-hypopnea index (AHI) and body mass index (BMI) were compared between these two groups. Patients were divided into mild OSAHS group, moderate OSAHS group and severe OSAHS group according to the severity of OSAHS, and GERD symptom score, sleep stage and arterial oxygen saturation(SaO2) were compared among these three groups. Results The prevalence of GERD in patients with OSAHS were 58%. The symptom score, AHI and BMI of patients with GERD were significantly higher than those of patients without GERD (P<0.05). The number of patients in severe OSAHS group was significantly larger than those in mild OSAHS group and moderate OSAHS group (P<0.05), the degree of anoxia in severe OSAHS group was more severe than that in mild OSAHS group (P<0.01), while there was no significant difference in GERD symptom score among these three groups (P>0.05). Conclusion OSAHS is closely related to GERD, and treatment with nasal continuous positive airway pressure (nCPAP) combined with antireflux drugs may yield better outcomes for patients with OSAHS and pathological GERD.

Key words: obstructive sleep apnea, gastroesophageal reflux disease, apnea-hypopnea index