阻塞性睡眠呼吸暂停的长期预后

H Jang, J Lee, U Ryu, D Park, S Mun
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摘要

【摘要】目的探讨未经治疗的OSA患者的严重程度与长期预后的关系,并将其与手术治疗的OSA患者的预后进行比较。材料与方法本研究回顾性分析了2009年至2022年间79例被诊断为OSA的患者的医疗记录,这些患者要么接受了手术治疗,要么没有接受治疗。两次接受多导睡眠图(PSG)检查的患者,根据呼吸暂停低通气指数(AHI)将患者细分为轻度、中度、重度组,比较OSA严重程度随时间的变化。结果本研究包括43例(54%)未接受治疗的患者和36例(46%)接受了包括扁桃体切除术和小舌或腭咽手术的患者。在未经治疗的患者中,整体组、轻度和重度亚组的AHI值随时间没有显著变化,但中度组的AHI值显著升高(p=0.017)。与未经治疗的患者相比,手术治疗,特别是扁桃体切除术,导致AHI值显著下降,特别是在手术后36个月内(p=0.000)。然而,对于随访期超过36个月的患者,行扁桃体切除术与未行扁桃体切除术的患者AHI值差异无统计学意义。结论:未经治疗的中度OSA患者AHI值随着时间的推移而恶化,强调了积极治疗的必要性。手术干预可在36个月内降低AHI值,但术后可能导致症状恶化。
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P097 The Fate of Obstructive Sleep Apnea in Long-term
Abstract Objective This study aims to investigate the relationships of the severity of OSA and the long-term results of OSA in untreated patients and to compare them with the results of OSA patients who were operated. Materials and Methods The study retrospectively analyzed medical records of 79 individuals who were diagnosed with OSA, who either underwent surgical treatment or received no treatment from 2009 to 2022. Among the patients who underwent polysomnography (PSG) twice, the patients were subdivided by mild, moderate, severe groups according to apnea-hypopnea index (AHI) and the changes in OSA severity over time were compared. Results This study included 43 patients (54%) who received no treatment and 36 patients (46%) who had undergone surgery including tonsillectomy with or without uvula or palatopharyngeal procedures. Among the untreated patients, there was no significant changes in AHI values over time for the overall group, the mild and severe subgroups, but the moderate group showed a significant increase in AHI values (p=0.017). Surgical treatment, specifically tonsillectomy, resulted in a significant decrease in AHI values compared to untreated patients, particularly within 36 months after the procedure (p=0.000). However, for patients with a follow-up period of more than 36 months, the difference in AHI values was not statistically significant between those who underwent tonsillectomy and those who did not. Conclusions Untreated moderate OSA patients show worsening of AHI values over time, highlighting the need for proactive treatment. Surgical intervention can reduce AHI values within 36 months but may lead to worsening of symptoms afterwards.
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