粉尘螨抗原滴剂对阻塞性睡眠呼吸暂停低通气综合征合并变应性鼻炎患者经鼻正压通气治疗依从性的影响研究

The effect of dust mite antigen drops on the compliance of patients with OSAHS and allergic rhinitis before and after treatment with nCPAP

摘要:

目的探讨粉尘螨抗原滴剂对阻塞性睡眠呼吸暂停低通气综合征（obstructive sleep apnea hypopnea syndrom,OSAHS）合并变应性鼻炎（allergic rhinitis，AR）患者经鼻正压通气（nose continuous positive airway pressure，nCPAP）治疗依从性的影响。方法门诊筛选66例同时患有对粉尘螨过敏的持续性AR和中重度OSAHS的且应用nCPAP治疗的成人患者（年龄＞18岁），均给予粉尘螨抗原抗过敏正规治疗1年，比较患者治疗前后nCPAP的95%有效使用压力值、每晚nCPAP治疗的时间、在不应用呼吸机时的每小时鼾声指数及嗜睡程度爱泼沃斯嗜睡量表（epworth slepp iness scale，ESS）评分。结果合并粉尘螨抗原阳性AR的中重度OSAHS患者经正规抗过敏治疗后，患者使用nCPAP的95%有效压力值，由（12.76±3.68）cmH2O降至治疗后的（8.83±2.62）cmH2O（P＜0.05），每晚使用时间由(4.58±1.69)h增加至(6.83±2.36)h（P＜0.05），不用呼吸机状态下每小时鼾声指数由治疗前的(386.67±50.68)次/h降至(268.82±32.58)次/h（P＜0.05），嗜睡程度ESS评分由(22.36±1.28)分降至（15.68±1.02）分（P＜0.05）。结论粉尘螨抗原滴剂能够降低合并AR的中重度OSAHS患者使用nCPAP的有效压力值，增加其使用时间，改善其鼾声指数，减轻白天嗜睡程度，能够提高患者对nCPAP治疗的依从性。

关键词:阻塞性睡眠呼吸暂停低通气综合征|变应性鼻炎|经鼻正压通气治疗|粉尘螨

Abstract:

Objectiveto investigate the effect of dust mite antigen drops on the compliance of patients with obstructive sleep apnea hypopnea syndrom (OSAHS) with allergic rhinitis (AR)via nose continuous positive airway pressure (nCPAP).Methods66 adult outpatients (age >18 years old) with persistent AR and moderate or severe OSAHS who suffered from dust mite allergy were screened out and treated with nCPAP. All patients were given regularly antiallergic treatment with dust mite antigen for one year. It was comparing to the 95% effective pressure value of nCPAP before and after treatment, the time of nCPAP treatment every night, and hourly snoring index and sleepiness scale (ESS) during without application of ventilator.Resultsafter regular antiallergic treatment, 95% effective pressure of nCPAP was decreased from （12.76±3.68）cmH2O to （8.83±2.62）cmH2O (P<0.05) after treatment in moderate and severe OSAHS patients with dust mite antigen positive AR, and the use time per night increased from(4.58±1.69)h to (6.83±2.36)h (P<0.05). The snore index per hour without ventilator decreased from (386.67±50.68) times/h before treatment to (268.82±32.58) times/h (P<0.05), and the ESS (Epworth Sleeping Scale, ESS) score decreased from (22.36±1.28)points to (15.68±1.02）points (P<0.05).ConclusionDustmite antigen drops can reduce the effective pressure of nCPAP in moderate to severe OSAHS patients with AR, increase the time of use, improve the snoring index, reduce daytime sleepiness, and improve the compliance of patients with nCPAP.

Key words:Obstructive sleep apnea hypopnea syndrome (OSAHS)|Allergic rhinitis (AR)|Nasal positive pressure ventilation therapy (nCPAP)| Dust mite