山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 134-138.doi: 10.6040/j.issn.1673-3770.0.2019.565

• 综述 • 上一篇    

阻塞性睡眠呼吸暂停综合征与咽喉反流性疾病相关研究进展

王宏艳,王三春综述滕博,葛敏审校   

  1. 王宏艳, 王三春 综述滕博, 葛敏 审校吉林大学第二医院 耳鼻咽喉头颈外科, 吉林 长春 130022
  • 收稿日期:2019-11-08 出版日期:2020-07-20 发布日期:2020-08-28
  • 基金资助:
    吉林省长春市朝阳区科技发展计划项目(201918032534);吉林省科技厅项目(TC010171429)

Advances in the study of obstructive sleep apnea syndrome and laryngopharyngeal reflux diseaseWANG Hongyan, WANG SanchunOverview TENG Bo, GE Min Guidance Department of Otolaryngology Head & Neck Surgery, the Second Hospital of Jilin University, Changchun 130022, Jilin, ChinaAbstract:

Obstructive sleep apnea syndrome(OSAS)and laryngopharyngeal reflux disease(LPRD)are two common diseases in otolaryngology. In recent years, with the increasing incidence, these diseases have affected the health of more and more people. As research on these two diseases continues to expand, the correlation between them has captured the attention of a number of scholars. In this study, we reviewed the recently published literature on the two diseases, concluding that there is a correlation between them. We have also elaborated on the factors and mechanisms of their mutual influence, analyzed the existing treatment methods of OSAS and LPRD, and provided new ideas for further refinement of the diagnosis and treatment.   

  1. Key words: Obstructive sleep apnea syndrome;
    Laryngeal reflux disease;
    Correlation阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome, OSAS)是一种睡眠呼吸障碍性疾病, 其特征是上呼吸道狭窄以及睡眠依赖性上呼吸道塌陷, 导致通气周期性减少或停止, 随之发生缺氧、高碳酸血症或觉醒［1］。咽喉反流性疾病(laryngopharyngeal reflux disease, LPRD)指胃内容物反流至食管上括约肌(upper esophageal sphincter, UES)以上部位(包括咽部、喉部、鼻腔、气管等部位), 造成局部黏膜损伤, 表现为咽异物感、咳嗽、声嘶等一系列症状的一类疾病［2］。在对上述两种疾病的研究过程中, 发现两者存在相关性, 受到人们的关注与深究, 现将目前相关于两者研究的现状及进展作一综述。
  • Received:2019-11-08 Online:2020-07-20 Published:2020-08-28

PDF (PC)

200

摘要： 阻塞性睡眠呼吸暂停综合征(OSAS)与咽喉反流性疾病(LPRD)是耳鼻喉科两种常见的疾病,近年来由于发病率逐渐增高,影响着越来越多人的健康。随着对这两种疾病研究的深入,两者之间的相关性引起了广大学者的重视。回顾近几年研究二者的相关文献,得出两者之间存在相关性的结论,阐述两者之间相互影响的因素、机制,并分析OSAS与LPRD的治疗方法,为进一步探寻两者的诊治提供新思路。

关键词: 阻塞性睡眠呼吸暂停综合征, 咽喉反流性疾病, 相关性

Abstract: Obstructive sleep apnea syndrome(OSAS)and laryngopharyngeal reflux disease(LPRD)are two common diseases in otolaryngology. In recent years, with the increasing incidence, these diseases have affected the health of more and more people. As research on these two diseases continues to expand, the correlation between them has captured the attention of a number of scholars. In this study, we reviewed the recently published literature on the two diseases, concluding that there is a correlation between them. We have also elaborated on the factors and mechanisms of their mutual influence, analyzed the existing treatment methods of OSAS and LPRD, and provided new ideas for further refinement of the diagnosis and treatment.

Key words: Obstructive sleep apnea syndrome, Laryngeal reflux disease, Correlation

中图分类号: 

  • R766.7
[1] Veasey SC, Rosen IM. Obstructive sleep apnea in adults[J]. N Engl J Med, 2019, 380(15): 1442-1449. doi:10.1056/NEJMcp1816152.
[2] Salihefendic N, Zildzic M, Cabric E. Laryngopharyngeal reflux disease-LPRD[J]. Med Arch, 2017, 71(3): 215-218. doi:10.5455/medarh.2017.71.215-218.
[3] Eryılmaz A, Erien L, Demir UL, et al. Management of patients with coexisting obstructive sleep apnea and laryngopharyngeal reflux disease[J]. Eur Arch Otorhinolaryngol, 2012, 269(12): 2575-2580. doi:10.1007/s00405-012-2062-z.
[4] Xiao YL, Liu FQ, Li J, et al. Gastroesophageal and laryngopharyngeal reflux profiles in patients with obstructive sleep apnea/hypopnea syndrome as determined by combined multichannel intraluminal impedance-pH monitoring[J]. Neurogastroenterol Motil, 2012, 24(6): e258-e265. doi:10.1111/j.1365-2982.2012.01920.x.
[5] Erdem D, Yılmaz YF, Özcan M, et al. Correlation of sleep-disordered breathing and laryngopharyngeal reflux: a two-channel triple-sensor pHmetry catheter study[J]. Eur Arch Otorhinolaryngol, 2018, 275(10): 2585-2592. doi:10.1007/s00405-018-5107-0.
[6] Elhennawi DM, Ahmed MR, Abou-Halawa AS. Correlation of obstructive sleep apnoea and laryngopharyngeal reflux: phmetry study[J]. Clin Otolaryngol, 2016, 41(6): 758-761. doi:10.1111/coa.12640.
[7] Wang CC, Lien HC, De Virgilio A, et al. Airway pH monitoring in patients with suspected obstructive sleep apnoea using the Dx-pH oropharyngeal probe: preliminary report of a prospective cohort study[J]. Clin Otolaryngol, 2014, 39(6): 352-358. doi:10.1111/coa.12297
[8] Rodrigues MM, Dibbern RS, Santos VJ, et al. Influence of obesity on the correlation between laryngopharyngeal reflux and obstructive sleep apnea[J]. Braz J Otorhinolaryngol, 2014, 80(1): 5-10. doi:10.5935/1808-8694.20140004.
[9] Wu JC, Mui LM, Cheung CM, et al. Obesity is associated with increased transient lower esophageal sphincter relaxation[J]. Gastroenterology, 2007, 132(3): 883-889. doi:10.1053/j.gastro.2006.12.032.
[10] Halum SL, Postma GN, Johnston C, et al. Patients with isolated laryngopharyngeal reflux are not obese[J]. Laryngoscope, 2005, 115(6): 1042-1045. doi:10.1097/01.MLG.0000162656.05715.57.
[11] Qu Y, Ye JY, Han DM, et al. Esophageal functional changes in obstructive sleep apnea/hypopnea syndrome and their impact on laryngopharyngeal reflux disease[J]. Chin Med J, 2015, 128(16): 2162-2167. doi:10.4103/0366-6999.162506.
[12] 张赛, 尤乐都斯. 食管动力和反流事件在 OSAHS 发病机制中意义[J]. 中华胃食管反流病电子杂志, 2014, 1(1): 28-33. doi:10.3877/cma.j.issn.1674-6899.2014.01.008. ZHANG Sai, YOU Ledusi. Esophageal dynamic and laryngopharyngeal reflux play a role in pathogenesis of OSAHS[J]. Chinese Journal of Gastroesphageal Reflux Disease(Electronic Edition), 2014, 1(1): 28-33. doi:10.3877/cma.j.issn.1674-6899.2014.01.008.
[13] 傅中明, 王华英, 俞万钧. 阻塞性睡眠呼吸暂停低通气综合征与咽喉反流的关系[J]. 中国现代医生, 2019, 57(2): 5-7, 11. FU Zhongming, WANG Huaying, YU Wanjun. Relationship between obstructive sleep apnea hypopnea syndrome and pharyngea reflux[J]. China Modern Doctor, 2019, 57(2): 5-7, 11.
[14] Patel D, Vaezi MF. Normal esophageal physiology and laryngopharyngeal reflux[J]. Otolaryngol Clin North Am, 2013, 46(6): 1023-1041. doi:10.1016/j.otc.2013.08.010.
[15] Wang AM, Wang G, Huang N, et al. Association between laryngopharyngeal reflux disease and autonomic nerve dysfunction[J]. Eur Arch Otorhinolaryngol, 2019, 276(8): 2283-2287. doi:10.1007/s00405-019-05482-w.
[16] Palma JA, Urrestarazu E, Lopez-Azcarate J, et al. Increased sympathetic and decreased parasympathetic cardiac tone in patients with sleep related alveolar hypoventilation[J]. Sleep, 2013, 36(6): 933-940. doi:10.5665/sleep.2728.
[17] Somers VK, Dyken ME, Clary MP,et al. Sympathetic Neural Mechanisms in Obstructive Sleep Apnea[J]. J Clin Invest, 1995, 96(4):1897-904.
[18] Liang JX, Zhang XM, He XM, et al. The independent and combined effects of respiratory events and cortical arousals on the autonomic nervous system across sleep stages[J]. Schlaf Atmung, 2018, 22(4): 1161-1168. doi:10.1007/s11325-018-1669-8.
[19] 孙娜, 陈晓平. 咽喉反流与耳鼻咽喉科疾病[J]. 山东大学耳鼻喉眼学报, 2016, 30(6): 85-89. doi:10.6040/j.issn.1673-3770.0.2016.213 SUN Na, CHEN Xiaoping. Laryngopharyngeal reflux and otorhinolaryngology diseases[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2016, 30(6): 85-89. doi:10.6040/j.issn.1673-3770.0.2016.213
[20] Aviv J E, Liu H, Kaplan S T, et al. Laryngopharyngeal Sensory Deficits in Patients with Laryngopharyngeal Reflux and Dysphagia[J]. Annals of Otology, Rhinology & Laryngology, 2000, 109(11):1000-1006.
[21] Payne RJ, Kost KM, Frenkiel S, et al. Laryngeal inflammation assessed using the reflux finding score in obstructive sleep apnea[J]. Otolaryngol Head Neck Surg, 2006, 134(5): 836-842. doi:10.1016/j.otohns.2006.01.012.
[22] Aguero GC, Lemme EMO, Alvariz Â, et al. Prevalência de queixas supra-esofágicas em pacientes com doenças do refluxo erosiva e não-erosiva[J]. Arq Gastroenterol, 2007, 44(1): 39-43. doi:10.1590/s0004-28032007000100009.
[23] Lee YC, Kwon OE, Park JM, et al. Do laryngoscopic findings reflect the characteristics of reflux in patients with laryngopharyngeal reflux?[J]. Clin Otolaryngol, 2018, 43(1):137-143. doi: 10.1111/coa.12914.
[24] Eskiizmir G, Kezirian E. Is there a vicious cycle between obstructive sleep apnea and laryngopharyngeal reflux disease?[J]. Med Hypotheses, 2009, 73(5): 706-708. doi:10.1016/j.mehy.2009.04.042.
[25] 钟旭, 王智凤, 黄席珍, 等. 睡眠呼吸暂停与胃食管反流的关系及持续正压通气的疗效[J]. 中华内科杂志, 1998, 37(4): 231-234. ZHONG Xu, WANG Zhifeng, HUANG Xizhen, et al. The relation between obstructive sleep apnea and nocturnal gastroesophageal reflux and the therapeutic use of nasal continuous positive airway pressure[J]. Chinese Journal of Internal Medicine, 1998, 37(4): 231-234.
[26] Patigaroo SA, Hashmi SF, Hasan SA, et al. Clinical manifestations and role of proton pump inhibitors in the management of laryngopharyngeal reflux[J]. Indian J Otolaryngol Head Neck Surg, 2011, 63(2): 182-189. doi:10.1007/s12070-011-0253-3.
[27] 张帆, 彭一纯, 冯宇莉. 雷贝拉唑对咽喉反流伴阻塞性睡眠呼吸暂停低通气综合征患者的疗效分析[J]. 牡丹江医学院学报, 2013, 34(1): 42-44. doi:10.3969/j.issn.1001-7550.2013.01.020.
[28] 张萍, 饶远生, 张丽川, 等. 奥美拉唑联合多潘立酮治疗阻塞性睡眠呼吸暂停低通气综合征伴咽喉反流性疾病的临床效果[J]. 中国医药, 2016, 11(5): 667-671. doi:10.3760/cma.j.issn.1673-4777.2016.05.011. ZHANG Ping, RAO Yuansheng, ZHANG Lichuan, et al. Clinical effect of omeprazole combined with domperidone in treating obstructive sleep apnea-hypopnea syndrome complicated with laryngopharyngeal reflux disease[J]. China Medicine, 2016, 11(5): 667-671. doi:10.3760/cma.j.issn.1673-4777.2016.05.011.
[29] Yoon YH, Park KW, Lee SH, et al. Efficacy of three proton-pump inhibitor therapeutic strategies on laryngopharyngeal reflux disease; a prospective randomized double-blind study[J]. Clin Otolaryngol, 2019, 44(4): 612-618. doi:10.1111/coa.13345.
[30] Altinta A, Soylu A, Yegin Y, et al. Impact of laryngopharyngeal reflux on the levels of depression and anxiety in patients with obstructive sleep apnea syndrome[J]. J Craniofac Surg, 2017, 28(2): e121-e124. doi:10.1097/SCS.0000000000003302.
[31] 齐智伟, 张淑君, 张宇丽, 等. 手术治疗OSA合并咽喉反流患者的疗效分析[J]. 临床耳鼻咽喉头颈外科杂志, 2019(10):923-925,931.doi: 10.13201/j.issn.1001-1781.2019.10.006 QI Zhiwei, ZHANG Shujun, ZHANG Yuli, et al. The surgical effect on obstructive sleep apnea with laryngopharyngeal reflux[J]. Journal of Clinical Otorhinolaryngology Head And Neck Surgery, 2019(10):923-925,931. doi: 10.13201/j.issn.1001-1781.2019.10.006.
[32] Kim SJ, Kim HY, Jeong JI, et al. Changes in the Reflux Symptom Index After Multilevel Surgery for Obstructive Sleep Apnea[J]. Clin Exp Otorhinolaryngol, 2017,10(3):259-264. doi: 10.21053/ceo.2017.00052.
[33] Lechien JR, Huet K, Khalife M, et al. Alkaline, protein, low-fat and low-acid diet in laryngopharyngeal reflux disease: Our experience on 65 patients[J]. Clin Otolaryngol, 2019, 44(3):379-384. doi: 10.1111/coa.13269.
[34] Wasilewska J, Semeniuk J, Cudowska B, et al. Respiratory response to proton pump inhibitor treatment in children with obstructive sleep apnea syndrome and gastroesophageal reflux disease[J]. Sleep Med, 2012, 13(7): 824-830. doi:10.1016/j.sleep. 2012.04.016.
[1] 王磊,王刚,吴玮,刘红丹,徐冰心,李鑫,韩浩伦,李保卫,丁瑞英,李连勇. 口咽、食管同步Dx-pH检测研究咽喉反流性疾病[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 101-106.
[2] 吴兆坤,朱新华. 腺样体扁桃体切除术治愈儿童阻塞性睡眠呼吸暂停综合征的偏误研究[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 148-152.
[3] 宋凡,黄炜峻,许华俊,关建,易红良. 阻塞性睡眠呼吸暂停综合征患者颈动脉弹性与氧化应激反应的关系[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 99-104.
[4] 季迪, 陈祥, 余林. 软腭平面手术联合舌骨悬吊术治疗阻塞性睡眠呼吸暂停综合征效果的Meta分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 124-130.
[5] 刘燕,魏萍,寇巍,胡思洁,武小芳,刘萌雅,陈成,姚红兵. 儿童腺样体肥大与耳鼻咽喉科常见疾病关系的研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 149-154.
[6] 闫志刚,张慧慧,于丹,刘岩,文连姬,王迪. 成人阻塞性睡眠呼吸暂停综合征患者认知功能障碍的诊断及治疗研究进展[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 155-161.
[7] 郎永耀,杨云,刘晴,徐林弟,林子萍. 咽喉反流性疾病的影响因素及治疗效果分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 119-123.
[8] 殷敏,程雷. 鼾症命名之我见[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 19-22.
[9] 胡安,邢艳莉,陈晓平,薛晓成,张燚,胥伟华. 咽喉反流伴阻塞性睡眠呼吸暂停低通气综合征患者的治疗及其咽喉反流体征评分、症状指数特点[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 86-89.
[10] 张静祎,王文一,张庆泉. 原发于结膜的黏膜相关淋巴组织淋巴瘤一例报告[J]. 山东大学耳鼻喉眼学报, 2018, 32(6): 121-122.
[11] 刘大炜,张宇,李成林,陈秀梅,宋西成. 加速康复外科在儿童OSAS围手术期中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 19-22.
[12] 朱明娟,邢凯,亢泽峰,刘健. 甲状腺相关性眼病的诊断及治疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 110-113.
[13] 王刚,吴玮,王磊,刘红丹,徐小杭,徐冰心,丁瑞英,周莹,韩浩伦,龚敬,李保卫,孙喆喆. Ryan指数与反流症状指数量表、反流体征量表在咽喉反流性疾病诊断中的相关性分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(4): 48-52.
[14] 谢洪彬,杨美娜,陈青山,刘旭阳,樊宁. IgG4相关性眼病伴继发性青光眼病例分析[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 99-102.
[15] 冀帅飞,张婕,严宏. 年龄相关性黄斑变性患者人工晶状体的选择[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 36-39.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发